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Thoracic and Cardiovascular Surgeon

Giulio Porcedda, Alice Brambilla, Silvia Favilli, Bruno Murzi, Lorenzo Mirabile, Roberto Baggi, Luigi Arcieri
BACKGROUND:  Left pulmonary artery (LPA) sling (PAS) is a vascular ring, which is frequently associated with long-segment tracheal stenosis (TS). Mortality rate in operated children is still high, especially in cases of severe tracheal hypoplasia and/or associated congenital heart defects (CHDs). We report our experience of treatment and follow-up in a pediatric cohort of patients affected by PAS with severe tracheobronchial involvement. METHODS:  From 2005 to 2017, we enrolled 11 children diagnosed with PAS and congenital TS requiring surgical intervention...
February 11, 2019: Thoracic and Cardiovascular Surgeon
Philippe Grieshaber, Sina Möller, Borros Arneth, Peter Roth, Bernd Niemann, Harald Renz, Andreas Böning
BACKGROUND:  Prediction, early diagnosis, and therapy of cardiac surgery-associated acute kidney injury (CSA-AKI) are challenging. We prospectively tested a staged approach to identify patients at high risk for CSA-AKI combining clinical risk stratification and early postoperative quantification of urinary biomarkers for AKI. METHODS:  All patients, excluding those on chronic hemodialysis, undergoing scheduled surgery with cardiopulmonary bypass between August 2015 and July 2016 were included...
February 11, 2019: Thoracic and Cardiovascular Surgeon
Wanjun Ren, Yuejuan Du, Huili Jiang, Dongmei Xu
BACKGROUND:  Chronic kidney disease has become a serious public health problem in China. Our study is to explore effect of hydraulic expansion on arteriovenous fistula (AVF) of hemodialysis patients. METHODS:  A total of 190 patients with end-stage renal disease (ESRD) were randomly divided into hydraulic expansion group ( n  = 117) and conventional surgery group ( n  = 73). Age, sex, the cause of ESRD, height, weight, body mass index (BMI), blood pressure, and diameter of artery and vein from ultrasonography before surgery from patients were recorded...
February 9, 2019: Thoracic and Cardiovascular Surgeon
Thomas Puehler, Armin Zittermann, Mohamad Dia, Eric Emmel, Mustafa Gercek, Jochen Börgermann, Kavous Hakim-Meibodi, Jan Gummert
BACKGROUND:  Coronary artery bypass grafting is the first-line therapy for severe multivessel coronary artery disease. We aimed to investigate the clinical outcome in patients undergoing isolated off-pump surgery with the single or bilateral internal mammary artery (SIMA or BIMA) approach. METHODS:  We performed a propensity score-matched analysis in 1,852 consecutive patients, aged 50 to 70 years, who underwent myocardial revascularization at our institution between July 2009 and August 2016...
February 9, 2019: Thoracic and Cardiovascular Surgeon
Yasser Menaissy, Ihab Omar, Basem Mofreh, Mohamed Alassal
BACKGROUND:  The timing of surgical repair of tetralogy of Fallot (TOF) is a key to alleviate complications and for long-term survival. Total correction was usually performed at the age of 6 months or older under the notion of decreasing the surgical risk. However, avoiding palliation with an aortopulmonary shunt and early correction of systemic hypoxia appear to be of more benefit than the inborn surgical risk in low body weight patients. Our objective was to assess early/midterm survival and operative complications and to analyze patients, surgical techniques, and morphological risk factors to determine their effects on outcomes...
February 9, 2019: Thoracic and Cardiovascular Surgeon
Jeremy Smelt, Antonia Pontiki, Marjan Jahangiri, Kawal Rhode, Arjun Nair, Andrea Bille
OBJECTIVES:  Patients undergoing surgery for locally advanced lung cancer involving the chest wall require anatomical lung with extensive en-bloc chest wall resection and appropriate reconstruction.In this proof-of-concept study, we aimed to produce personalized three-dimensional (3D)-printed chest wall prosthesis for a patient undergoing chest wall resection and reconstruction using clinically obtained computed tomography (CT) data. METHODS:  Preoperative CT scans of three patients undergoing chest wall resection were analyzed and the areas of resection segmented...
February 8, 2019: Thoracic and Cardiovascular Surgeon
Hagen Gorki, Julia Nakamura, Andreas Kunert, Markus Hoenicka, Andreas Liebold
BACKGROUND:  From the results of a previous study, it remained to be investigated if a perioperative rise of few tested coagulation and inflammation markers is caused by conventional cardiopulmonary bypass (CPB) itself or rather by direct recirculation of pericardial fluids. METHODS:  Forty-eight patients operated on with conventional CPB for myocardial revascularization were randomized either for direct recirculation of pericardial suction fluids or for cell saving (CS)...
February 6, 2019: Thoracic and Cardiovascular Surgeon
Jeong Su Cho, Hyo Yeong Ahn, Yeong Dae Kim, Hoseok I, Jung Seop Eom
BACKGROUND:  Prolonged air leakage is a problem that can frequently develop in patients with a secondary spontaneous pneumothorax (SSP) or in those who undergo thoracic surgery. However, the management of an air leak is difficult and reoperation might be avoided due to several reasons including adhesions. Herein, we introduce a fibrin glue application under pleurography (FGAP) and short-term outcomes in patients who underwent this procedure. METHODS:  FGAP was performed in 20 patients with an intractable persistent air leakage who had poor lung function, comorbidities to undergo general anesthesia and were expected severe adhesions due to previous surgery...
February 6, 2019: Thoracic and Cardiovascular Surgeon
Anneke Neumann, Luise Vöhringer, Julia Fischer, Migdat Mustafi, Wilke Schneider, Tobias Krüger, Christian Schlensak
BACKGROUND:  Emergency coronary artery bypass grafting (CABG) in the setting of acute coronary syndrome (ACS) has been associated with increased morbidity and mortality. Avoiding cardiopulmonary bypass might be advantageous, but the role of off-pump CABG (OPCAB) remains controversial, as it has been associated with incomplete revascularization in several studies. The objective of this study was to evaluate the feasibility, efficacy, and outcome of OPCAB surgery in ACS patients. METHODS:  We performed a retrospective review of ACS patients who underwent on-pump CABG (ONCAB) or OPCAB, either emergently or delayed, at our institution...
February 6, 2019: Thoracic and Cardiovascular Surgeon
Joseph A Hill
No abstract text is available yet for this article.
January 29, 2019: Thoracic and Cardiovascular Surgeon
Fumiaki Kimura, Takayuki Kadohama, Hiroto Kitahara, Hayato Ise, Sentaro Nakanishi, Nobuyuki Akasaka, Hiroyuki Kamiya
BACKGROUND:  This study aimed to evaluate the significance of serum neuron-specific enolase (NSE) level as a predictor of neurologic injury in thoracic aortic surgery. METHODS:  We neurologically assessed 60 consecutive patients who underwent thoracic aortic surgery for thoracic aortic aneurysm ( n  = 26) and aortic dissection ( n  = 34). Using moderate hypothermic circulatory arrest with antegrade cerebral perfusion, total arch replacement and hemiarch replacement were performed in 37 and 23 patients, respectively...
January 22, 2019: Thoracic and Cardiovascular Surgeon
Jie Hu, Qian Wang, Zhirong Tong, Juanya Shen, Jinlong Liu, Yanjun Sun, Haibo Zhang
BACKGROUND:  The desirable distance, defined as offset, between the central line of the superior vena cava (SVC) and the intra-atrial conduit after an intra-atrial conduit (IAC) Fontan's procedure remained unclear. We compared the hemodynamic features using virtual surgery with different offset designs in our study. METHODS:  Three-dimensional models of IAC Fontan's procedure were reconstructed according to the magnetic resonance imagings (MRIs) of three patients, then four models for each patient with different offsets equaling 100, 67, 33, and 0% of the diameter of the IVC were reconstructed...
January 22, 2019: Thoracic and Cardiovascular Surgeon
Martin Hartrumpf, Ralf-Uwe Kuehnel, Filip Schroeter, Robert Haase, Magdalena L Laux, Roya Ostovar, Johannes M Albes
BACKGROUND:  Conventional stented valves (CV) remain gold standard for aortic valve disease. Bovine prostheses have been improved and rapid deployment valves (RDV) have arrived in the recent decade. We compare clinical and hemodynamic short-term outcome of six bovine valves. METHODS:  We retrospectively evaluated 829 consecutive patients (all-comers) receiving bovine aortic valve replacement (AVR). Four CV from different manufacturers (Mitroflow, Crown, Perimount, Trifecta) and two RDV (Perceval, Intuity) were compared in terms of pre-, intra-, and postprocedural data...
January 22, 2019: Thoracic and Cardiovascular Surgeon
Yukinori Yamagata, Kazuyuki Saito, Kosuke Hirano, Masatoshi Oya
In esophagectomy for thoracic esophageal cancer, chylothorax may develop at a certain frequency. For chylothorax, conservative treatment is selected first, but if it is not improved, thoracic duct (TD) ligation is considered. In general, transthoracic approach is chosen to reach the TD. However, it is sometimes difficult to identify the TD due to adhesion in the thoracic cavity. Hence, we selected a laparoscopic transhiatal approach to the TD. We introduce the procedure of our laparoscopic transhiatal TD ligation technique...
January 22, 2019: Thoracic and Cardiovascular Surgeon
Calvin S H Ng, Zerui Zhao, Hao Long, Rainbow W H Lau
Small pulmonary lesions can be difficult to localize during video-assisted thoracoscopic surgery. Electromagnetic navigation bronchoscopy (ENB) dye marking of the lesion, particularly when guided by cone beam computed tomography in the hybrid operating room (HOR), is an emerging approach. However, issues with confirmation of dye injection and intraoperative visualization of the colored dye can be unpredictable and challenging. To address these uncertainties, we present our technique of ENB dye marking localization of lung nodule using the triple-contrast dye method in the HOR...
January 11, 2019: Thoracic and Cardiovascular Surgeon
Konstantin Zhigalov, Marcin Szczechowicz, Ahmed Mashhour, Sabreen Mkalaluh, Maxim Isaev, Bakitbek Kadyraliev, Jerry Easo, Juergen Ennker, Harald Eichstaedt, Alexander Weymann
BACKGROUND:  The main purpose of this article is to investigate the impact of previous sternotomy (PS) on the outcome of three different left ventricular assist devices (LVAD). METHODS:  Between June 2007 and February 2018, a total of 121 patients received HeartMate II (60.3%), HeartWare (12.4%), or HeartMate III (27.3%), with or without previous sternotomy (PS and non-PS groups, respectively). Propensity matching resulted in 44 patient pairs. The primary end point was overall survival at 30 days, 1 year, 2, and 5 years, postoperatively...
January 8, 2019: Thoracic and Cardiovascular Surgeon
Antonia Schulz, Nicodème Sinzobahamvya, Mi-Young Cho, Wolfgang Böttcher, Oliver Miera, Mathias Redlin, Stanislav Ovroutski, Joachim Photiadis
BACKGROUND:  This study reports midterm results of high-risk patients with hypoplastic left ventricle treated with initial bilateral pulmonary artery banding (PAB) before secondary Norwood procedure (NP). METHODS:  Retrospective study of 17 patients admitted between July 2012 and February 2017 who underwent this treatment strategy because diagnosis or clinical status was associated with high risk for NP. Survival was compared with that of patients who underwent primary NP...
January 4, 2019: Thoracic and Cardiovascular Surgeon
Paulo A Amorim, Mahmoud Diab, Mario Walther, Gloria Färber, Andreas Hagendorff, Robert O Bonow, Torsten Doenst
BACKGROUND:  Prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR) may affect survival but data are conflicting. It is assessed by relating effective orifice area (EOA) to body surface area (EOAi). EOA is patient-specific as the result of flow-velocity times area at the individual patient's outflow tract levels (LVOTA ) divided by trans-prosthetic flow velocity. However, some studies use projected EOAs (i.e., valve size associated EOAs from other patient populations) to assess how PPM affects outcome...
January 4, 2019: Thoracic and Cardiovascular Surgeon
Thomas V Bilfinger
No abstract text is available yet for this article.
January 4, 2019: Thoracic and Cardiovascular Surgeon
Peter Murin, Wolfgang Boettcher, Shinichi Ozaki, Alexa Wloch, Mi-Young Cho, Mathias Redlin, Oliver Miera, Nicodème Sinzobahamvya, Joachim Photiadis
BACKGROUND:  We routinely start cardiopulmonary bypass (CPB) for pediatric congenital heart surgery without homologous blood, due to circuit miniaturization, and blood-saving measures. Blood transfusion is applied if hemoglobin concentration falls under 8 g/dL, or it is postponed to after coming off bypass or after operation. How this strategy impacts on postoperative mortality and morbidity, in infants weighing ≤ 7 kg? METHODS:  Six-hundred fifteen open-heart procedures performed from January 2014 to June 2018 were selected...
January 2, 2019: Thoracic and Cardiovascular Surgeon
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