Non-intubated spontaneous ventilation offers better short term outcome for mediastinal tumor surgery
Publication date: Available online 7 June 2019Source: The Annals of Thoracic SurgeryAuthor(s): Hengrui Liang, Jun Liu, Shilong Wu, Yaoliang Zhang, Hui Liu, Hanyu Yang, Yi Zhao, Zhexue Hao, Wenhua Liang, Jianxing HeAbstractBackgroundNon-intubated 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 versus intubated-anaesthesia VATS (I-VATS) on early outcomes of mediastinal lesion resection.MethodsPatien...
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

At Ross-Konno Operation in an Infant with a Quadricuspid Pulmonary Valve and Anomalous Aortic Origin of the Right Coronary Artery
We describe a unique case in which both these anomalies co-existed in an infant who underwent a successful Ross-Konno operation. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Interposition of retrosternal pedicled jejunum after hypopharyngolaryngo-esophagogastrectomy
Publication date: Available online 7 June 2019Source: The Annals of Thoracic SurgeryAuthor(s): Alfred Maier, Joerg Lindenmann, Georg Hammer, Paul Swatek, Nicole Fink-Neuboeck, Melanie Fediuk, Dietmar Thurnher, Freyja Maria Smolle-JuettnerAbstractReconstruction of the upper gastrointestinal tract presents a surgical challenge after esophago-gastrectomy, especially when it includes hypopharyngolaryngectomy. Reconstructrion is generally undertaken with interposed colon as a substitute conduit, but carries several risks. Alternative reconstruction of the foregut with pedicled retrosternal jejunum anastomosed at the level of th...
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Esophago-gastric preservation in the surgical management of proximal esophageal cancer
ConclusionsTrans-cervical pharyngo-laryngo-cervico-esophagectomy should be considered in patients with isolated cervical esophageal tumors. Pharyngo-laryngo-cervico-esophagectomy allows adequate tumor resection whilst preserving the esophagus and stomach below. Operative morbidity and mortality outcomes were improved without compromising oncological control. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Postcardiotomy Veno-Arterial Extracorporeal Membrane Oxygenation in Patients Aged ≥70 Years.
CONCLUSIONS: Advanced age should not be considered a contraindication for postcardiotomy VA-ECMO. However, in view of the high risk of early mortality, a meaningful scrutiny is needed before using VA-ECMO after cardiac surgery in the elderly. PMID: 31185202 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Biancari F, Saeed D, Fiore A, Dalén M, Ruggieri VG, Jónsson K, Gatti G, Zipfel S, Dell'Aquila AM, Chocron S, Bounader K, Amr G, Settembre N, Pälve K, Loforte A, Gabrielli M, Livi U, Lechiancole A, Pol M, Netuka I, Spadaccio C, Pettinari M, De Keyzer D, Tags: Ann Thorac Surg Source Type: research

Benefits of Endoscopic Vein Harvesting in Coronary Artery Bypass Grafting.
CONCLUSIONS: Apart from the benefits on leg wound complications, endoscopic vein harvesting was comparable to open vein harvesting in terms of rate of repeat revascularization and quality of life. PMID: 31185203 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kroeze VJ, Lam KY, van Straten AHM, Houterman S, Soliman-Hamad MA Tags: Ann Thorac Surg Source Type: research

Optimizing Venous Drainage for Minimal Access Right Atrial Procedures.
Abstract We have created a shaped tube that connects the superior and inferior vena caval orifices to drain the blood from superior vena cava to the inferior vena cava and eventually to the extracorporeal circulation through the femoral vein. We specifically use it in cardiac surgeries in the case of right atriotomy operations requiring femoral vein cannulation, such as tricuspid valvuloplasty or replacement, atrioventricular septal defect repairing and so on. This method would improve the exposure and drainage, simplify operation steps and shorten the operation time. Both femoral artery and vein cannulation are g...
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Wu S, Ma L, Li C, Ni Y Tags: Ann Thorac Surg Source Type: research

Aortic and pulmonary valve reconstruction using autologous pericardium in narrow annuli.
Abstract A 71-year-old woman with pulmonary artery aneurysm had a complication of pulmonary valve stenosis with estimated right ventricular pressure 135 mmHg and severe aortic valve stenosis with peak pressure gradient 112 mmHg. Coronary angiography revealed stenosis of the left coronary arterial system. Because she presented with narrow pulmonary annulus (16.7 mm) and aortic annulus (19.7 mm), we decided to perform aortic and pulmonary valve reconstruction using autologous pericardium. We performed aneurysmorrhaphy of the pulmonary artery, dual-valve reconstruction, and coronary artery bypass grafting. Postoperat...
Source: The Annals of Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Takahashi Y, Shibata T, Fujii H, Morisaki A, Sakon Y, Yamane K, Kishimoto N, Murakami T Tags: Ann Thorac Surg Source Type: research

Interposition of retrosternal pedicled jejunum after hypopharyngolaryngo-esophagogastrectomy.
Abstract Reconstruction of the upper gastrointestinal tract presents a surgical challenge after esophago-gastrectomy, especially when it includes hypopharyngolaryngectomy. Reconstructrion is generally undertaken with interposed colon as a substitute conduit, but carries several risks. Alternative reconstruction of the foregut with pedicled retrosternal jejunum anastomosed at the level of the base of the tongue is described for the first time. Total hypopharyngo-esophagogastrectomy is a relatively rare procedure that can be indicated with life-threatening caustic foregut injuries. While mild and moderate injuries c...
Source: The Annals of Thoracic Surgery - June 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Maier A, Lindenmann J, Hammer G, Swatek P, Fink-Neuboeck N, Fediuk M, Thurnher D, Smolle-Juettner FM Tags: Ann Thorac Surg Source Type: research

Cardiopulmonary Testing Prior to Lung Resection: What are Thoracic Surgeons Doing?
wn LM Abstract BACKGROUND: Cardiopulmonary assessment for lung resection is important for risk stratification, and the American College of Chest Physicians (ACCP) guidelines provide decision support. We ascertained thoracic surgeons' cardiopulmonary assessment practices and determined whether they are guideline concordant. METHODS: An anonymous survey was emailed to 846 thoracic surgeons who participate in the Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD). We analyzed survey responses by practice type (general thoracic [GT] vs cardiothoracic [CT]) and years in practice (0-9, 10-1...
Source: The Annals of Thoracic Surgery - June 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Clark JM, Marrufo AS, Kozower BD, Tancredi DJ, Nuño M, Cooke DT, Pollock BH, Romano PS, Brown LM Tags: Ann Thorac Surg Source Type: research

Repair of Aortic Valve Insufficiency and Ascending Aortic Aneurysm using Geometric Ring Annuloplasty.
Abstract This video demonstrates aortic valve repair during ascending aneurysm replacement. A 71-year-old male has congestive heart failure, Grade 3 aortic insufficiency (AI), and a 5.4 cm ascending aneurysm. On testing, the non-coronary leaflet is prolapsing, the annulus is 27 mm, and the leaflets size to a 21-mm ring. The ring is sutured beneath the aortic valve annulus with 9 horizontal mattress sutures. The non-coronary leaflet is plicated, correcting the prolapse. A 28 mm Dacron tube graft is sutured to the supra-coronary and distal aorta. After repair, AI is trivial with a 9 mmHg mean systolic gradient. The ...
Source: The Annals of Thoracic Surgery - June 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Gerdisch MW, Weaver SD, Rankin JS, Badhwar V Tags: Ann Thorac Surg Source Type: research

At Ross-Konno Operation in an Infant with a Quadricuspid Pulmonary Valve and Anomalous Aortic Origin of the Right Coronary Artery.
We describe a unique case in which both these anomalies co-existed in an infant who underwent a successful Ross-Konno operation. PMID: 31181204 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Bayle KM, Boston U, Sainathan S, Naik R, Knott-Craig CJ Tags: Ann Thorac Surg Source Type: research

Transcatheter Aortic Valve Replacement for Alkaptonuria-Associated Aortic Stenosis.
We present the case of a 71-year-old woman with alkaptonuria-associated aortic stenosis in whom a minimally invasive surgical aortic valve replacement was attempted but abandoned because of extensive root calcification. She subsequently underwent transfemoral transcatheter aortic valve replacement with an Edwards SAPIEN 3 valve (Edwards Lifesciences, Irvine, CA). To our knowledge, this is the first report of transcatheter aortic valve replacement for treating alkaptonuria-associated aortic stenosis, expanding potential treatment options for these patients. PMID: 31181205 [PubMed - as supplied by publisher] (Source: Th...
Source: The Annals of Thoracic Surgery - June 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Olive JK, Alnajar A, Gnanashanmugam S, Lamelas J Tags: Ann Thorac Surg Source Type: research

Non-intubated spontaneous ventilation offers better short term outcome for mediastinal tumor surgery.
Abstract BACKGROUND: Non-intubated 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 versus intubated-anaesthesia VATS (I-VATS) on early outcomes of mediastinal lesion resection. METHODS: Patients that underwent VATS resection for a mediastinal tumor between December 2015 and September 2018 were retrospectively included for analysis. Patients were divided into two groups according to a...
Source: The Annals of Thoracic Surgery - June 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Liang H, Liu J, Wu S, Zhang Y, Liu H, Yang H, Zhao Y, Hao Z, Liang W, He J Tags: Ann Thorac Surg Source Type: research

Esophago-gastric preservation in the surgical management of proximal esophageal cancer.
CONCLUSIONS: Trans-cervical pharyngo-laryngo-cervico-esophagectomy should be considered in patients with isolated cervical esophageal tumors. Pharyngo-laryngo-cervico-esophagectomy allows adequate tumor resection whilst preserving the esophagus and stomach below. Operative morbidity and mortality outcomes were improved without compromising oncological control. PMID: 31181207 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Chow VLY, Chan JYW, Law SYK Tags: Ann Thorac Surg Source Type: research

Impact of the Opioid Epidemic on Heart Transplantation: Donor Characteristics and Organ Discard
This study compared donor and recipient characteristics, outcomes, and reasons for organ discard between overdose-death donors (ODDs) and donors with all other mechanism of death.MethodsData on adult cardiac transplants from 2010 to 2017 were provided by the Scientific Registry of Transplant Recipients. Cardiac allografts used in multiple organ transplantations were excluded. Recipient and donor characteristics and organ discard were analyzed with regard to ODDs. Kaplan-Meier curves and log-rank tests described mortality survival.ResultsA total of 1,710 of 15,904 (10.8%) cardiac transplantations were from ODDs, approximate...
Source: The Annals of Thoracic Surgery - June 6, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Malleable tin plate exposure system for minimally invasive mitral valve surgery
Publication date: Available online 5 June 2019Source: The Annals of Thoracic SurgeryAuthor(s): Toshihiko Shibata, Yosuke Takahashi, Hiromichi Fujii, Akimasa Morisaki, Yoshito Sakon, Takashi MurakamiAbstractIn minimally invasive mitral valve surgery, exposure in the medial left atrium is occasionally poor. We constructed a flexible exposure system for minimally invasive surgery using a tin plate (99.9% pure tin). The tin plate is very flexible and embossed to prevent slippage, and is attached to a left atrial retractor. The folded tin plate is inserted into the left atrium via a minithoracotomy, and the plate is easily expa...
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Influence of age and the burden of ischemic injury on the outcome of Type A aortic dissection repair
Publication date: Available online 5 June 2019Source: The Annals of Thoracic SurgeryAuthor(s): Maximilian Kreibich, Bartosz Rylski, Martin Czerny, Matthias Siepe, Friedhelm Beyersdorf, Zehang Chen, Emanuela Branchetti, Prashanth Vallabhajosyula, Wilson Y. Szeto, Joseph E. Bavaria, Nimesh D. DesaiAbstractBackgroundTo evaluate operative details and postoperative outcomes in elderly patients according to the burden of ischemic injury.MethodsBetween 2002 and 2017, 1187 patients in two centers were operated on for aortic dissection Type A (ADA). Patients were grouped according to the Penn Classification: Class A n=628, Class B ...
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Extracorporeal life support in myocardial infarction-induced cardiogenic shock: Weaning success
ConclusionsEmergency ECLS is a valuable option among patients with AMI-induced CS with low and intermediate IABP SHOCK II risk scores. ECLS weaning is manageable but additional revascularization of all non-culprit lesions is mandatory after ECLS implementation. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Proficiency of Robotic Lobectomy Based on Prior Surgical Technique in the STS General Thoracic Database
ConclusionsOutcomes among all transition groups improved with experience. OR duration proficiency was challenging for all groups. CUSUM 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 - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Right Atrial Pressure Waveform Predicts Right Ventricular Failure after LVAD implantation
ConclusionsLess-distensible RV and elevated CVP/PCWP level were significant risks for RVF after LVAD implantation. This result suggested that analysis of not just the hemodynamic numbers, but also the pattern of waveforms is important to assess risk for RVF in LVAD candidates. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Reoperation with Coronary Reimplantation After Takeuchi Repair of Bland-White-Garland Syndrome
We present a 1-year-old male patient with Bland-White-Garland syndrome (anomalous origin of the left coronary artery from the pulmonary artery) who underwent coronary reimplantation. He had previously undergone Takeuchi procedure at 7 months of age. He was hospitalized because the patency of the intrapulmonary tunnel to the left coronary could not be confirmed by the routine computed tomography (CT) scan in an outpatient facility. The left coronary reimplantation was performed by extending the coronary artery with autologous pulmonary artery wall. The postoperative course was uneventful. The patient’s left ventricula...
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Malleable tin plate exposure system for minimally invasive mitral valve surgery.
Abstract In minimally invasive mitral valve surgery, exposure in the medial left atrium is occasionally poor. We constructed a flexible exposure system for minimally invasive surgery using a tin plate (99.9% pure tin). The tin plate is very flexible and embossed to prevent slippage, and is attached to a left atrial retractor. The folded tin plate is inserted into the left atrium via a minithoracotomy, and the plate is easily expanded using forceps, as needed. The tin plate pushes the medial atrial wall outward, which provides an excellent view of the entire mitral valve. PMID: 31175867 [PubMed - as supplied b...
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Shibata T, Takahashi Y, Fujii H, Morisaki A, Sakon Y, Murakami T Tags: Ann Thorac Surg Source Type: research

Right Atrial Pressure Waveform Predicts Right Ventricular Failure after LVAD implantation.
CONCLUSIONS: Less-distensible RV and elevated CVP/PCWP level were significant risks for RVF after LVAD implantation. This result suggested that analysis of not just the hemodynamic numbers, but also the pattern of waveforms is important to assess risk for RVF in LVAD candidates. PMID: 31175868 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Samura T, Yoshioka D, Asanoi H, Toda K, Miyagawa S, Yoshikawa Y, Hata H, Kainuma S, Kawamura T, Kawamura A, Sakata Y, Sawa Y Tags: Ann Thorac Surg Source Type: research

Influence of age and the burden of ischemic injury on the outcome of Type A aortic dissection repair.
Abstract BACKGROUND: To evaluate operative details and postoperative outcomes in elderly patients according to the burden of ischemic injury. METHODS: Between 2002 and 2017, 1187 patients in two centers were operated on for aortic dissection Type A (ADA). Patients were grouped according to the Penn Classification: Class A n=628, Class B n=196, Class C n=224, Class BC n=139. The perioperative conditions and outcomes were analyzed. RESULTS: The likelihood of presenting in a Penn Class changed significantly with age (p=0.02). Also, the probability of ADA extension into the supra-aortic vessels (p
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kreibich M, Rylski B, Czerny M, Siepe M, Beyersdorf F, Chen Z, Branchetti E, Vallabhajosyula P, Szeto WY, Bavaria JE, Desai ND Tags: Ann Thorac Surg Source Type: research

Extracorporeal life support in myocardial infarction-induced cardiogenic shock: Weaning success.
CONCLUSIONS: Emergency ECLS is a valuable option among patients with AMI-induced CS with low and intermediate IABP SHOCK II risk scores. ECLS weaning is manageable but additional revascularization of all non-culprit lesions is mandatory after ECLS implementation. PMID: 31175870 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Wagner J, Tiller C, Dietl M, Ulmer H, Brenner C, Stastny L, Sommerauer F, Mair P, Ruttmann E, Innsbruck Liver-in-heart-Failure Program Tags: Ann Thorac Surg Source Type: research

Proficiency of Robotic Lobectomy Based on Prior Surgical Technique in the STS General Thoracic Database.
CONCLUSIONS: Outcomes among all transition groups improved with experience. OR duration proficiency was challenging for all groups. CUSUM may be useful to monitor proficiency in not only subsequent studies but in clinical practice. PMID: 31175871 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Feczko AF, Wang H, Nishimura K, Farivar AS, Bograd AJ, Vallières E, Aye RW, Louie BE Tags: Ann Thorac Surg Source Type: research

A Reoperation with Coronary Reimplantation After Takeuchi Repair of Bland-White-Garland Syndrome.
We present a 1-year-old male patient with Bland-White-Garland syndrome (anomalous origin of the left coronary artery from the pulmonary artery) who underwent coronary reimplantation. He had previously undergone Takeuchi procedure at 7 months of age. He was hospitalized because the patency of the intrapulmonary tunnel to the left coronary could not be confirmed by the routine computed tomography (CT) scan in an outpatient facility. The left coronary reimplantation was performed by extending the coronary artery with autologous pulmonary artery wall. The postoperative course was uneventful. The patient's left ventricular func...
Source: The Annals of Thoracic Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Zhang C, Hua Z, Liu J, Yan F, Wang X, Li S Tags: Ann Thorac Surg Source Type: research

Association between anemia and blood transfusion with long-term mortality following cardiac surgery
Publication date: Available online 4 June 2019Source: The Annals of Thoracic SurgeryAuthor(s): Hari Padmanabhan, Matthew J. Brookes, Alan M. Nevill, Heyman LuckrazAbstractBackgroundPreoperative anaemia and red blood cell (RBC) transfusion are both associated with in-hospital mortality after cardiac surgery. The aim of this study was to investigate the interactions between preoperative anaemia and RBC transfusion, and their effect on the long-term survival of patients undergoing cardiac surgery.MethodsBetween 2005 and 2012, 1,170 patients with anaemia who underwent elective or urgent cardiac surgery were included. A matched...
Source: The Annals of Thoracic Surgery - June 4, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term Safety of Minimally Invasive LVAD Discontinuation for Myocardial Recovery
ConclusionsThis minimally-invasive approach for LVAD discontinuation through outflow graft ligation, driveline removal and LVAD stoppage in setting of myocardial recovery avoids resternotomy risks. Despite leaving the LVAD in situ, risks of thromboembolism from residual hardware as well as infection risk to the inflow/outflow cannulas have not been evident. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 4, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Metachronous Thin-Walled Cavity Lung Cancers Exhibiting Variable Histopathology
We report a case of metachronous thin-walled cavity lung cancers exhibiting variable histopathology. A 70-year-old man visited our hospital because of a thin-walled cavity located in the right upper lobe, detected by chest computed tomography (CT). Right upper lobectomy was performed, and a histological diagnosis of squamous cell carcinoma was made. CT at 7 years post-treatment detected a new thin-walled cavity in the left lower lobe. Histopathology after video-assisted thoracic-left S6 segmentectomy revealed adenocarcinoma. Primary lung carcinoma may present with thin-walled cavities; postoperative screening can aid early...
Source: The Annals of Thoracic Surgery - June 4, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term Safety of Minimally Invasive LVAD Discontinuation for Myocardial Recovery.
CONCLUSIONS: This minimally-invasive approach for LVAD discontinuation through outflow graft ligation, driveline removal and LVAD stoppage in setting of myocardial recovery avoids resternotomy risks. Despite leaving the LVAD in situ, risks of thromboembolism from residual hardware as well as infection risk to the inflow/outflow cannulas have not been evident. PMID: 31173754 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 4, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kapoor K, Shah P, Bogar LJ, Edwards LG, Panjrath GS, Singh R Tags: Ann Thorac Surg Source Type: research

Association between anemia and blood transfusion with long-term mortality following cardiac surgery.
Abstract BACKGROUND: Preoperative anaemia and red blood cell (RBC) transfusion are both associated with in-hospital mortality after cardiac surgery. The aim of this study was to investigate the interactions between preoperative anaemia and RBC transfusion, and their effect on the long-term survival of patients undergoing cardiac surgery. METHODS: Between 2005 and 2012, 1,170 patients with anaemia who underwent elective or urgent cardiac surgery were included. A matched group of 1,170 non-anaemic patients was used as a control group. A binary logistic regression model was used. RESULTS: The median follow-...
Source: The Annals of Thoracic Surgery - June 4, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Padmanabhan H, Brookes MJ, Nevill AM, Luckraz H Tags: Ann Thorac Surg Source Type: research

Metachronous Thin-Walled Cavity Lung Cancers Exhibiting Variable Histopathology.
We report a case of metachronous thin-walled cavity lung cancers exhibiting variable histopathology. A 70-year-old man visited our hospital because of a thin-walled cavity located in the right upper lobe, detected by chest computed tomography (CT). Right upper lobectomy was performed, and a histological diagnosis of squamous cell carcinoma was made. CT at 7 years post-treatment detected a new thin-walled cavity in the left lower lobe. Histopathology after video-assisted thoracic-left S6 segmentectomy revealed adenocarcinoma. Primary lung carcinoma may present with thin-walled cavities; postoperative screening can aid early...
Source: The Annals of Thoracic Surgery - June 4, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Nakamura D, Kondo R, Makiuchi A, Itagaki H, Ishii K Tags: Ann Thorac Surg Source Type: research

Safe and effective ultrasound-guided myectomy and mitral valve repair for HCM
We report combined procedure of myectomy using intra-cardiac high-resolution ultrasonography and mitral bi-leaflet shortening in obstructive hypertrophic cardiomyopathy. Stepwise real-time verification of residual ventricular mass using high-resolution ultrasonic probe would be a potent armamentarium. This modality provides safe and effective myectomy, which has been most technically challenging surgical procedure for especially inexperienced surgeon. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Norwood Operation with Anterior Translocation of Pulmonary Artery
We present 2 cases of successful total cavopulmonary connection after Norwood operation using the right ventricle-to-pulmonary artery shunt with translocation of the pulmonary bifurcation anterior to the reconstructed neoaortic arch. This modification provided a better surgical access to an obstructive pulmonary artery at staged single ventricle strategy and a space for the growth of the pulmonary arteries. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Video-Assisted Thoracoscopic Pneumonectomy to Treat Complications of Unilateral Congenital Pulmonary
In this report, we describe a 37-year-old female with known congenital unilateral pulmonary venous stenosis and a unilateral hypoplastic right pulmonary artery who presented with recurrent episodes of hemoptysis requiring multiple catheter-based interventions and symptomatic pleural effusions requiring multiple large volume thoracenteses. The patient underwent successful video-assisted thoracoscopic pneumonectomy with resolution of symptoms. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Acute Type A Dissection Repair by High versus Low Volume Surgeons at a High-Volume Aortic Center
Publication date: Available online 31 May 2019Source: The Annals of Thoracic SurgeryAuthor(s): Juan B. Umana-Pizano, Alexander P. Nissen, Harleen K. Sandhu, Charles C. Miller, Andrei Loghin, Hazim J. Safi, Steven B. Eisenberg, Anthony L. Estrera, Tom C. NguyenAbstractBackgroundPrevious studies suggest improved outcomes for acute Type A dissections (ATAAD) treated at high-volume centers. It is unclear if outcomes are a result of individual surgeon experience or inherent resources available at high-volume centers. To explore this question, we stratified outcomes for ATAAD repair by low and high-volume surgeons at a high-volu...
Source: The Annals of Thoracic Surgery - June 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiopulmonary Bypass Before Anesthesia Induction In A Case Of Ruptured Ascending Aortic Aneurysm
We present a case of ruptured ascending aortic aneurysm with cardiac tamponade and cardiogenic shock, managed by awake cardiopulmonary bypass to avoid hemodynamic collapse. This represents an unconventional approach of establishing cardiopulmonary bypass, which in most cases is done post induction. Increased surgical bleeding from full heparinisation prior to sternotomy can be a problem, limiting visibility. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Video-assisted Versus 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 NSCLC 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 - June 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Off-Pump Versus On-Pump: Should graft flow confirmation at time of surgery become standard of care? (Reply)
Publication date: Available online 1 June 2019Source: The Annals of Thoracic SurgeryAuthor(s): A. Laurie Shroyer, Jacquelyn A. Quin, Brack Hattler (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiopulmonary Bypass Before Anesthesia Induction In A Case Of Ruptured Ascending Aortic Aneurysm.
We present a case of ruptured ascending aortic aneurysm with cardiac tamponade and cardiogenic shock, managed by awake cardiopulmonary bypass to avoid hemodynamic collapse. This represents an unconventional approach of establishing cardiopulmonary bypass, which in most cases is done post induction. Increased surgical bleeding from full heparinisation prior to sternotomy can be a problem, limiting visibility. PMID: 31163129 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 1, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Srivastava S, Das A, Khanuja JS, Pendharkar A, Ganesan PK Tags: Ann Thorac Surg Source Type: research

Off-Pump Versus On-Pump: Should graft flow confirmation at time of surgery become standard of care? (Reply).
PMID: 31163130 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 1, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Shroyer AL, Quin JA, Hattler B Tags: Ann Thorac Surg Source Type: research

Video-assisted Versus Thoracotomy Sleeve Lobectomy for Lung Cancer: a Propensity Matched Analysis.
CONCLUSIONS: VATS sleeve lobectomy is a safe and effective procedure associated with better postoperative recovery and equivalent oncological results, even for locally advanced NSCLC patients with an invasive tumor size larger than 3 cm or accompanying lymphatic invasion. PMID: 31163131 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - June 1, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Gao HJ, Jiang ZH, Gong L, Ma K, Ren P, Yu ZT, Wei YC Tags: Ann Thorac Surg Source Type: research

Norwood Operation with Anterior Translocation of Pulmonary Artery.
We present 2 cases of successful total cavopulmonary connection after Norwood operation using the right ventricle-to-pulmonary artery shunt with translocation of the pulmonary bifurcation anterior to the reconstructed neoaortic arch. This modification provided a better surgical access to an obstructive pulmonary artery at staged single ventricle strategy and a space for the growth of the pulmonary arteries. PMID: 31158349 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - May 31, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Saito T, Aoki M, Hagino I Tags: Ann Thorac Surg Source Type: research

Safe and effective ultrasound-guided myectomy and mitral valve repair for HCM.
We report combined procedure of myectomy using intra-cardiac high-resolution ultrasonography and mitral bi-leaflet shortening in obstructive hypertrophic cardiomyopathy. Stepwise real-time verification of residual ventricular mass using high-resolution ultrasonic probe would be a potent armamentarium. This modality provides safe and effective myectomy, which has been most technically challenging surgical procedure for especially inexperienced surgeon. PMID: 31158350 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - May 31, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Oishi K, Arai H, Oi K, Yashima M, Kuroki H, Fujiwara T, Takeshita M, Mizuno T Tags: Ann Thorac Surg Source Type: research

Acute Type A Dissection Repair by High versus Low Volume Surgeons at a High-Volume Aortic Center.
Abstract BACKGROUND: Previous studies suggest improved outcomes for acute Type A dissections (ATAAD) treated at high-volume centers. It is unclear if outcomes are a result of individual surgeon experience or inherent resources available at high-volume centers. To explore this question, we stratified outcomes for ATAAD repair by low and high-volume surgeons at a high-volume center. METHODS: We reviewed our institutional experience with ATAAD between 1999-2016 (n=580). To evaluate surgeon experience with ATAAD repair, we categorized surgeons as high volume (HVAS, cases>10 per year) or low volume aortic surgeons (LVAS, cases
Source: The Annals of Thoracic Surgery - May 31, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Umana-Pizano JB, Nissen AP, Sandhu HK, Miller CC, Loghin A, Safi HJ, Eisenberg SB, Estrera AL, Nguyen TC Tags: Ann Thorac Surg Source Type: research

Video-Assisted Thoracoscopic Pneumonectomy to Treat Complications of Unilateral Congenital Pulmonary.
In this report, we describe a 37-year-old female with known congenital unilateral pulmonary venous stenosis and a unilateral hypoplastic right pulmonary artery who presented with recurrent episodes of hemoptysis requiring multiple catheter-based interventions and symptomatic pleural effusions requiring multiple large volume thoracenteses. The patient underwent successful video-assisted thoracoscopic pneumonectomy with resolution of symptoms. PMID: 31158352 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - May 31, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Halpern AL, Weyant MJ Tags: Ann Thorac Surg Source Type: research

Surgical Age and Morbidity After Arterial Switch for Transposition of the Great Arteries
ConclusionsEarly complications after ASO do occur and are mostly associated with prematurity and need for aortic arch repair. Timing of surgical repair does not seem to influence the rate of these complications. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - May 30, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Partial Sternectomy to Prevent Rastelli Conduit Compression in Patients with Conotruncal Anomalies
We report two cases of redo cardiac surgeries in adult patients with conotruncal anomalies (double outlet right ventricle and transposition of the great arteries) with pulmonary stenosis who underwent the Rastelli procedure in childhood. Although the Rastelli operation is one of the best options for the patients, conduit stenosis occasionally developed due to compression by the anterior chest wall. To prevent compression by the sternum, we performed partial sternectomy with Rastelli conduit change. (Source: The Annals of Thoracic Surgery)
Source: The Annals of Thoracic Surgery - May 30, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research