Impact of Mesenchymal Stromal Cell Delivery through Cardiopulmonary Bypass on Postnatal Neurogenesis.
Abstract BACKGROUND: Neurodevelopmental impairment is an important challenge for survivors after neonatal surgery with cardiopulmonary bypass (CPB). The subventricular zone, where most neural stem/progenitors originate, plays a critical role in cortical maturation of the frontal lobe. Promoting neurogenesis in the subventricular zone is therefore a potential therapeutic target for preserving cortical growth. Mesenchymal stromal cells (MSCs) promote endogenous regeneration in the rodent brain. We investigated the impact of MSC delivery through CPB on neural stem/progenitor cells and neuroblasts (i.e. young neurons)...
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Maeda T, Sarkislali K, Leonetti C, Kapani N, Dhari Z, Al Haj I, Ulrey R, Hanley PJ, Jonas RA, Ishibashi N Tags: Ann Thorac Surg Source Type: research

Distal Embolic Protection in Impella 5.0 Explantation: "Loop & Snare" Technique.
Distal Embolic Protection in Impella 5.0 Explantation: "Loop & Snare" Technique. Ann Thorac Surg. 2019 Sep 26;: Authors: Kawabori M, Pramil V, Shindgikar P, Zhan Y, Warner KG, Rastegar H, Kapur NK, Chen FY, Couper GS Abstract The left ventricular assist device, Impella 5.0, has become widely accepted as a temporary mechanical circulatory support for patients in cardiogenic shock. Impella 5.0 is placed through an anastomosed graft. When removing the device, blood clot formation is noticed in the anastomosed graft. The blood clot has been reported to dislodge and embolize distally, causing...
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kawabori M, Pramil V, Shindgikar P, Zhan Y, Warner KG, Rastegar H, Kapur NK, Chen FY, Couper GS Tags: Ann Thorac Surg Source Type: research

Impact of Cerebral Perfusion on Outcomes of Aortic Surgery: STS Adult Cardiac Database Analysis.
CONCLUSIONS: For patients without dissection and requiring>30 minutes circulatory arrest, optimal cerebral protection strategies are deep hypothermia with either antegrade or retrograde cerebral perfusion; or moderate hypothermia with antegrade cerebral perfusion. PMID: 31563489 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Itagaki S, Chikwe J, Sun E, Chu D, Toyoda N, Egorova N Tags: Ann Thorac Surg Source Type: research

Automated Implantation of Artificial Mitral Chords: Preliminary Results from the Feasibility Trial.
Abstract PURPOSE: A novel chordal system enables automated implantation of artificial mitral chords to treat mitral regurgitation (MR). This paper summarizes the "first-in-man" initial clinical results. DESCRIPTION: The CHAGALL trial is a single arm, multi-center, prospective study to test the feasibility of this system for mitral repair. The interim clinical and echocardiographic results of the first 5 patients with a 12 months follow-up are presented. EVALUATION: Five patients (mean age 64 years) with severe MR received implantation of neochords with this device under cardiopulmonary bypass. ...
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Weber A, Rucinskas K, Janusauskas V, Zakarkaite D, Zuber M, Vogel R, Carrel T Tags: Ann Thorac Surg Source Type: research

Nationwide Analysis of 30-day Readmissions Following Esophagectomy: Causes, Costs, and Risk Factors.
Abstract BACKGROUND: Postsurgical readmissions are an increasingly scrutinized marker of healthcare quality. We sought to estimate the rate, risk factors, causes, and costs associated with readmissions following esophagectomy in a large, nationally-representative cohort. METHODS: We studied patients from the Nationwide Readmissions Database undergoing esophagectomy from 2010 to 2014. Data was collected on the prevalence and indications for readmission within 30 days as well as the hospital-, procedure-, and patient-level risk factors as determined by multivariable logistic regression. RESULTS: Among 13,2...
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Goel NJ, Iyengar A, Kelly JJ, Mavroudis C, Lancaster C, Williams NN, Dempsey DT, Kucharczuk J Tags: Ann Thorac Surg Source Type: research

A new paradigm in mechanical circulatory support: 100 patient experience.
Abstract BACKGROUND: Acutely decompensated heart failure presents a complicated challenge. Established temporary support measures have significant adverse effects. A novel minimally invasive temporary left ventricular assist device (LVAD), the Impella 5.0, has been developed to support these patients. METHODS: Patients from January 2014 to September 2018 at a single center with acutely decompensated heart failure who failed medical management and required additional support using an Impella 5.0 were evaluated in a retrospective manner using a prospectively maintained database. Patients were bridged using the ...
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Chung JS, Emerson D, Ramzy D, Akhmerov A, Megna D, Esmailian F, Kobashigawa J, Cole RM, Moriguchi J, Trento A Tags: Ann Thorac Surg Source Type: research

Venoarterial ECMO Without Routine Systemic Anticoagulation Decreases Adverse Events.
CONCLUSIONS: The absence of routine systemic anticoagulation for patients supported on VA-ECMO is not associated with higher mortality, pump failure, or thrombotic complications. Patients had a lower requirement for blood product transfusions, and there was no incidence of HIT. VA-ECMO patients without other indications for anticoagulation can be treated without systemic anticoagulation during their VA-ECMO course. PMID: 31563493 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Wood KL, Ayers B, Gosev I, Kumar N, Melvin AL, Barrus B, Prasad S Tags: Ann Thorac Surg Source Type: research

Granulomatous Inflammation Presenting as a Pulmonary Artery Mass.
Abstract Granulomatous fungal infections are common worldwide, and can result in mediastinal lymphadenopathy. However, infectious pulmonary artery masses are rare and have only been associated with tuberculosis or mucormycosis. Here, we present the first case of histoplasmosis resulting in a pulmonary artery mass, which was treated with debulking and reconstruction of pulmonary vasculature. PMID: 31563494 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Chang SH, Patterson GA Tags: Ann Thorac Surg Source Type: research

Longitudinal Outcomes After Surgical Repair of PostInfarction Ventricular Septal Defect in the Medicare population.
This study uses short-term clinical data from the Society of Thoracic Surgeons (STS) National Database linked with Medicare data to examine longer-term outcomes in these patients. METHODS: This was a retrospective review of the STS National Database to link with Medicare data all adults (≥65 years) who underwent VSD repair following a myocardial infarction between 2008-2012. The primary outcome was 1-year mortality. Risk factors for 1-year survival were modeled using a multivariable Cox regression. RESULTS: A total of 537 patients were identified using the STS database and medicare linkage. Median age was 74 y...
Source: The Annals of Thoracic Surgery - September 25, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Arnaoutakis GJ, Kilic A, Conte JV, Kim S, Brennan JM, Gulack BC, Edwards FH, Jacobs JP, Sultan I Tags: Ann Thorac Surg Source Type: research

Outcomes of Conventional Cardiac Surgery in Patients with Severely Reduced Ejection Fraction in the Modern Era
ConclusionsDespite a high-risk profile, patients with reduced preoperative LVEF can undergo conventional cardiac surgery with acceptable outcomes. The majority of patients, including those on preoperative inotropes, were alive and free from heart failure readmissions at 5-years. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Outcome of Extra-anatomic Bypass for Midaortic Syndrome Caused by Takayasu Arteritis
ConclusionsExtra-anatomic bypass for Takayasu arteritis is safe and effective and can be useful for left ventricular unloading and reduction of organ ischemia. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Hemodynamics of Spiral-Flow-Generated Mechanical Assistance
Publication date: Available online 23 September 2019Source: The Annals of Thoracic SurgeryAuthor(s): Pablo Huang Zhang, Colin Tkatch, Dmitri Vainchtein, J. Yasha KreshAbstractBackgroundMechanical circulatory support (MCS) devices are being increasingly used as destination therapy in end-stage heart failure patients. Although current devices have significantly improved survival rates, the resulting hemodynamics remains non-physiological. Spiral forms of blood flow are known to exist in the large arteries (e.g., aorta) and serve as a biomimetic-motivation for generating these physiologically-adapted flow regimes. This resear...
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Tracheal bridge for reconstruction of the upper airway in double tracheal stenosis
We present a clinical case of a patient with double tracheal stenosis secondary to prolonged intubation and tracheostomy for which a healthy well vascularized tracheal bridge was used to achieve a tracheal reconstruction without tension The key point in performing this type of reconstruction is allowing a tension-free cervical and thoracic anastomosis. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Replacement in Bioprosthetic Failure:Insights from The Society of Thoracic Surgeons National Database
ConclusionsThe number of patients undergoing SAVR for degenerated bioprosthesis is decreasing in U.S, particularly among older and high-risk patients. These trends may reflect the adoption of valve-in-valve transcatheter aortic valve replacement for degenerated bioprosthesis after its FDA approval in 2015. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Risk Aversion in Cardiac Surgery: 15 Year Trends in a Statewide Analysis
Publication date: Available online 23 September 2019Source: The Annals of Thoracic SurgeryAuthor(s): Robert B. Hawkins, J Hunter Mehaffey, William Z. Chancellor, Clifford E. Fonner, Alan M. Speir, Mohammed A. Quader, Jeffrey B. Rich, Irving L. Kron, Gorav Ailawadi, Investigators for the Virginia Cardiac Services Quality InitiativeAbstractBackgroundWith a rising emphasis on public reporting, we hypothesized that select hospitals are becoming increasingly risk-averse by avoiding high-risk operations. Further, we evaluated the association between risk-averse practices, outcomes and publicly reported quality measures.MethodsCl...
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

External Compressive Bracing with Initial Reduction of Pectus Carinatum: Compliance is the Key
Publication date: Available online 23 September 2019Source: The Annals of Thoracic SurgeryAuthor(s): Stephanie Fraser, Leanne Harling, Akshay Patel, Tom Richards, Ian HuntAbstractBackgroundTo assess the impact of manipulation and a tailored programme for compressive bracing on the quality of life of patients with flexible pectus carinatumMethods249 sequential patients attending clinic for assessment of pectus carinatum deformities underwent out-patient manipulation and then followed a prescribed schedule of continuous external compressive bracing but without significant progressive tightening.ResultsThere was successful su...
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Patient-reported symptoms for esophageal cancer patients undergoing curative intent treatment
ConclusionsThis study demonstrates a high symptom burden for EC patients undergoing curative intent therapy. Targeted treatment of common severe symptoms, and increased support for patients at risk for severe symptoms, may enhance patient quality of life. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Morphomic factors associated with complete response to neoadjuvant therapy in esophageal carcinoma
Publication date: Available online 21 September 2019Source: The Annals of Thoracic SurgeryAuthor(s): Chien-Hung Chiu, Peng Zhang, Andrew C. Chang, Brian A. Derstine, Brian E. Ross, Binu Enchakalody, Nidhi V. Shah, Stewart C. Wang, Yin-Kai Chao, Jules LinAbstractBackgroundIn patients undergoing neoadjuvant chemoradiotherapy (nCRT) followed by surgery for locally advanced esophageal squamous cell carcinoma (ESCC), patients with a pathological complete response (pCR) have the greatest benefit. The purpose of this study was to identify morphomic factors obtained from pre-treatment computed tomography scans associated with a pa...
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Lymphovascular Invasion Is Associated with Mutational Burden and PD-L1 in Resected Lung Cancer
ConclusionsNSCLC tumors with elevated TMB and PD-L1 expression are associated with LVI and increased intratumoral immune cell infiltration. These findings may potentially improve patient selection for checkpoint inhibitor therapy trials in the adjuvant setting. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Replacement in Bioprosthetic Failure:Insights from The Society of Thoracic Surgeons National Database.
CONCLUSIONS: The number of patients undergoing SAVR for degenerated bioprosthesis is decreasing in U.S, particularly among older and high-risk patients. These trends may reflect the adoption of valve-in-valve transcatheter aortic valve replacement for degenerated bioprosthesis after its FDA approval in 2015. PMID: 31557477 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kalra A, Raza S, Hussain M, Shorbaji K, Delozier S, Deo SV, Khera S, Kleiman NS, Reardon MJ, Kolte D, Gupta T, Mustafa R, Bhatt DL, Sabik JF Tags: Ann Thorac Surg Source Type: research

Aortic Hemodynamics of Spiral-Flow-Generated Mechanical Assistance.
Abstract BACKGROUND: Mechanical circulatory support (MCS) devices are being increasingly used as destination therapy in end-stage heart failure patients. Although current devices have significantly improved survival rates, the resulting hemodynamics remains non-physiological. Spiral forms of blood flow are known to exist in the large arteries (e.g., aorta) and serve as a biomimetic-motivation for generating these physiologically-adapted flow regimes. This research aimed to study the potential benefits of generating spiral flow at the MCS outflow graft and the resultant flow-fields in the aorta, including recircula...
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Zhang PH, Tkatch C, Vainchtein D, Kresh JY Tags: Ann Thorac Surg Source Type: research

Outcomes of Conventional Cardiac Surgery in Patients with Severely Reduced Ejection Fraction in the Modern Era.
CONCLUSIONS: Despite a high-risk profile, patients with reduced preoperative LVEF can undergo conventional cardiac surgery with acceptable outcomes. The majority of patients, including those on preoperative inotropes, were alive and free from heart failure readmissions at 5-years. PMID: 31557479 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Seese L, Sultan I, Gleason T, Wang Y, Thoma F, Navid F, Kilic A Tags: Ann Thorac Surg Source Type: research

Risk Aversion in Cardiac Surgery: 15 Year Trends in a Statewide Analysis.
Abstract BACKGROUND: With a rising emphasis on public reporting, we hypothesized that select hospitals are becoming increasingly risk-averse by avoiding high-risk operations. Further, we evaluated the association between risk-averse practices, outcomes and publicly reported quality measures. METHODS: Clinical data from 78,417 patients undergoing cardiac surgery (2002-2016) from a regional consortium was paired with publicly available reimbursement and quality data. High-risk surgery was defined as predicted risk of mortality ≥5%. Hospital risk aversion was defined as a significant decrease in both high-ris...
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Hawkins RB, Mehaffey JH, Chancellor WZ, Fonner CE, Speir AM, Quader MA, Rich JB, Kron IL, Ailawadi G, Investigators for the Virginia Cardiac Services Quality Initiative Tags: Ann Thorac Surg Source Type: research

Clinical Outcome of Extra-anatomic Bypass for Midaortic Syndrome Caused by Takayasu Arteritis.
CONCLUSIONS: Extra-anatomic bypass for Takayasu arteritis is safe and effective and can be useful for left ventricular unloading and reduction of organ ischemia. PMID: 31557481 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kim YS, Cho YH, Sung K, Kim DK, Chung S, Park TK, Kim WS Tags: Ann Thorac Surg Source Type: research

External Compressive Bracing with Initial Reduction of Pectus Carinatum: Compliance is the Key.
Abstract BACKGROUND: To assess the impact of manipulation and a tailored programme for compressive bracing on the quality of life of patients with flexible pectus carinatum METHODS: 249 sequential patients attending clinic for assessment of pectus carinatum deformities underwent out-patient manipulation and then followed a prescribed schedule of continuous external compressive bracing but without significant progressive tightening. RESULTS: There was successful sustained reduction of the deformity in 244 patients with high reported rates of concordance (98%) and satisfaction (94%). Patients experienced a redu...
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Fraser S, Harling L, Patel A, Richards T, Hunt I Tags: Ann Thorac Surg Source Type: research

Tracheal bridge for reconstruction of the upper airway in double tracheal stenosis.
We present a clinical case of a patient with double tracheal stenosis secondary to prolonged intubation and tracheostomy for which a healthy well vascularized tracheal bridge was used to achieve a tracheal reconstruction without tension The key point in performing this type of reconstruction is allowing a tension-free cervical and thoracic anastomosis. PMID: 31557483 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: García-Herreros LG, Granada J, Díaz A, Santivañez JJ Tags: Ann Thorac Surg Source Type: research

Evolution of Tricuspid Regurgitation after Repair of Degenerative Mitral Regurgitation
ConclusionsAfter MV repair, but without concomitant tricuspid valve repair, a number of patients had progression in their TR. There was a signal of harm in patients having moderate preoperative TR in terms of mortality, but this finding is exploratory and requires investigation. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Morphomic factors associated with complete response to neoadjuvant therapy in esophageal carcinoma.
Abstract BACKGROUND: In patients undergoing neoadjuvant chemoradiotherapy (nCRT) followed by surgery for locally advanced esophageal squamous cell carcinoma (ESCC), patients with a pathological complete response (pCR) have the greatest benefit. The purpose of this study was to identify morphomic factors obtained from pre-treatment computed tomography scans associated with a pathological complete response in ESCC. METHODS: We retrospectively analyzed patients with ESCC treated with nCRT who underwent esophagectomy between 2006 and 2016. Clinical and morphomic characteristics pre-nCRT were analyzed to identify ...
Source: The Annals of Thoracic Surgery - September 21, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Chiu CH, Zhang P, Chang AC, Derstine BA, Ross BE, Enchakalody B, Shah NV, Wang SC, Chao YK, Lin J Tags: Ann Thorac Surg Source Type: research

Lymphovascular Invasion Is Associated with Mutational Burden and PD-L1 in Resected Lung Cancer.
CONCLUSIONS: NSCLC tumors with elevated TMB and PD-L1 expression are associated with LVI and increased intratumoral immune cell infiltration. These findings may potentially improve patient selection for checkpoint inhibitor therapy trials in the adjuvant setting. PMID: 31550464 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 21, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Mitchell KG, Negrao MV, Parra ER, Li J, Zhang J, Dejima H, Vaporciyan AA, Swisher SG, Weissferdt A, Antonoff MB, Cascone T, Roarty E, Wistuba II, Heymach JV, Gibbons DL, Zhang J, Sepesi B Tags: Ann Thorac Surg Source Type: research

Patient-reported symptoms for esophageal cancer patients undergoing curative intent treatment.
CONCLUSIONS: This study demonstrates a high symptom burden for EC patients undergoing curative intent therapy. Targeted treatment of common severe symptoms, and increased support for patients at risk for severe symptoms, may enhance patient quality of life. PMID: 31550465 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 21, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Gupta V, Allen-Ayodabo C, Davis L, Zhao H, Hallet J, Mahar AL, Ringash J, Kidane B, Darling G, Coburn NG Tags: Ann Thorac Surg Source Type: research

Evaluation of tricuspid valve repair without annuloplasty ring in Intravenous drug abusers
ConclusionsValve repair can be considered a proper surgical plan in isolated endocarditis among IV drug abusers with results comparable to a replacement, ensuring the minimal use of foreign material in such patients. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Editorial Board
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Board of Directors
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Contents
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The MITRA-FR Trial Vs the COAPT Trial: More Complementary Than Contradictory?
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): Jessica G.Y. Luc, Jonathan C. Hong, Anson W Cheung, Richard C Cook, Peter L Skarsgard, Jian Ye, Tom C. Nguyen (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Eye of the Beholder: The Reinvention of Seeing
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): Richard L. Prager (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Whole Brain Leadership for Creating Resonant Multidisciplinary Health Care Teams
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): Ross M. Ungerleider, Jamie Dickey UngerleiderThe culture of health care creates important challenges for health care professionals. In particular, we work in a culture that is (1) hierarchical, (2) competitive, and (3) perfectionistic. Unfortunately, the consequence of acquiescing to those demands is contrary to promoting Resonant teamwork, and it is important for leaders of multidisciplinary teams to understand how to create environments that flatten the hierarchy (by encouraging all members of the team to contribute; and t...
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Importance of a Diverse Specialty: Introducing the STS Workforce on Diversity and Inclusion
This report will discuss the background for the creation of the Workforce on Diversity and Inclusion, describe the “return on investment” in diversity, the current state of diversity in surgery, illustrate STS members’ views on the importance of a diverse specialty, and present current and future activities of the Workforce on Diversity and Inclusion. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiopulmonary Testing Before Lung Resection: What Are Thoracic Surgeons Doing?
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): James M. Clark, Angelica S. Marrufo, Benjamin D. Kozower, Daniel J. Tancredi, Miriam Nuño, David T. Cooke, Brad H. Pollock, Patrick S. Romano, Lisa M. BrownBackgroundCardiopulmonary assessment for lung resection is important for risk stratification, and the American College of Chest Physicians (ACCP) guidelines provide decision support. We ascertained the cardiopulmonary assessment practices of thoracic surgeons and determined whether they are guideline concordant.MethodsAn anonymous survey was emailed to 846 thoracic...
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Proficiency of Robotic Lobectomy Based on Prior Surgical Technique in The Society of Thoracic Surgeons General Thoracic Database
ConclusionsOutcomes among all transition groups improved with experience. Operating room duration proficiency was challenging for all groups. Cumulative sum may be useful to monitor proficiency in not only subsequent studies but in clinical practice. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Computed Tomography Histogram Approach to Predict Lymph Node Metastasis in Patients With Clinical Stage IA Lung Cancer
This study aimed to clarify whether CT histogram analysis of tumors can be used to classify patients with clinical stage 0 to IA non-small cell lung cancer according to pathologic lymph node (pN) status.MethodsPredictive factors associated with pN metastasis were identified from the derivation dataset including 629 patients with clinical stage 0 to IA non-small cell lung cancer who underwent complete resection with lymph node dissection (surgeries between 2008 and 2013). The validation dataset including 238 patients (surgeries between 2014 and 2015) were subsequently reevaluated. Clinicosurgical factors, including CT histo...
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Esophagogastric Preservation in the Surgical Management of Proximal Esophageal Cancer
ConclusionsTranscervical pharyngo-laryngo-cervico-esophagectomy should be considered in patients with isolated cervical esophageal tumors. Pharyngo-laryngo-cervico-esophagectomy allows adequate tumor resection while preserving the esophagus and stomach below. Operative morbidity and mortality outcomes were improved without compromising oncologic control. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes and Long-term Survival After Pulmonary Retransplantation: A Single-Center Experience
ConclusionsReLTx is a reasonable option for a selected group of patients. Ideally, a number of well-established risk factors are avoided and the ReLTx is performed more than 1 year after the PLTx. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Nonintubated Spontaneous Ventilation Offers Better Short-term Outcome for Mediastinal Tumor Surgery
Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): Hengrui Liang, Jun Liu, Shilong Wu, Yaoliang Zhang, Hui Liu, Hanyu Yang, Yi Zhao, Zhexue Hao, Wenhua Liang, Jianxing HeBackgroundNonintubated spontaneous ventilation video-assisted thoracoscopic surgery (NI-VATS) has been investigated to reduce the adverse effects of tracheal intubation, mechanical ventilation, and general anesthesia in several thoracic diseases. We comparatively assess the comparison between NI-VATS vs intubated anesthesia VATS (I-VATS) on early outcomes of mediastinal lesion resection.MethodsPatients who u...
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Assessment and Management of Dysphagia After Lung Resection: A Randomized Controlled Trial
ConclusionsEarly detection of postoperative dysphagia can significantly decrease the risk of postoperative pneumonia in patients undergoing lung resection.Visual Abstract (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Three-Dimensional Optical Imaging for Pectus Excavatum Assessment
Conclusions3D optical imaging of patients with pectus excavatum is emerging as an alternative method to assess HIs without the use of ionizing radiation. Additional studies will focus on volumetric quantification of chest wall deformities, using the 3D capabilities of this technology. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Video-Assisted Vs Thoracotomy Sleeve Lobectomy for Lung Cancer: A Propensity Matched Analysis
ConclusionsVATS sleeve lobectomy is a safe and effective procedure associated with better postoperative recovery and equivalent oncological results, even for locally advanced non-small cell lung cancer patients with an invasive tumor size larger than 3 cm or accompanying lymphatic invasion. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Influence of Clinical T Factor on Predicting Pathologic N Factor in Resected Lung Cancer
ConclusionsA consolidation size of more than 2 cm and GGO− were predictors of pN+, and the clinical T factor of the 8th Edition was a stronger predictor of the pN+ status than that of the 7th edition. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Rural-Urban Differences in Access to Thoracic Surgery in the United States, 2010 to 2014
We examined the U.S. thoracic surgery workforce using the 2010 and 2014 Area Health Resource Files. We calculated the density of thoracic surgeons per 100,000 persons for each year at the state and county level. We performed descriptive statistics and developed maps highlighting changes over time and geographic regions.ResultsDespite an overall increase in thoracic surgeons from 2010 to 2014, we observed declining density nationwide (1.5% change) and in sparsely populated states. The difference in thoracic surgeon density widened slightly between 2010 from 0.80 per 100,000 compared with 0.84 per 100,000 in 2014 in all rura...
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Houston Methodist Lung Transplant Risk Model: A Validated Tool for Pretransplant Risk Assessment
This study sought to create a risk stratification model using only preoperative recipient data to predict 1-year postoperative mortality during the pretransplant assessment.MethodsData of lung transplant recipients at Houston Methodist Hospital in Houston, Texas from January 2009 to December 2014 were extracted from the United Network for Organ Sharing (UNOS) database. Patients were randomly divided into development and validation cohorts. Cox proportional-hazards models were conducted. Variables associated with 1-year mortality after transplantation were assigned weights on the basis of the beta coefficients, and ris...
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research