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Interactive Cardiovascular and Thoracic Surgery

Wenbiao Zhang, Shuangjiang Li, Longqi Chen, Qinghua Zhou
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether low serum albumin (sAlb) was associated with postoperative bronchopleural fistula (BPF) in patients undergoing pulmonary resections. Altogether 660 papers were found using the reported search, of which 5 retrospective cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
March 19, 2019: Interactive Cardiovascular and Thoracic Surgery
Marcin Ostrowski, Tomasz Marjański, Robert Dziedzic, Małgorzata Jelitto-Górska, Katarzyna Dziadziuszko, Edyta Szurowska, Rafał Dziadziuszko, Witold Rzyman
OBJECTIVES: The European Society of Thoracic Surgeons' recommendations confirm the implementation of lung cancer screening in Europe. We compared 2 screening programmes, the Pilot Pomeranian Lung Cancer Screening Programme (pilot study) and the Moltest Bis programme, completed in a single centre. METHODS: A total of 8649 healthy volunteers (aged 50-75 years, smoking history ≥20 pack-years) were enrolled in a pilot study between 2009 and 2011, and a total of 5534 healthy volunteers (aged 50-79, smoking history ≥30 pack-years) were enrolled in the Moltest Bis programme between 2016 and 2017...
March 18, 2019: Interactive Cardiovascular and Thoracic Surgery
Jens K Skov, Hans-Henrik Kimose, Jacob Greisen, Carl-Johan Jakobsen
OBJECTIVES: In this propensity-matched study we investigated the outcome after grafting with either a single vein or a sequential vein grafting strategy. Outcomes were primarily risk of reintervention and death in the short, intermediate and long term (10 years). MATERIALS: In the period from 2000 to 2016, data from 24 742 patients undergoing coronary artery bypass grafting were extracted from the Western Denmark Heart Registry, where data are registered perioperatively...
March 18, 2019: Interactive Cardiovascular and Thoracic Surgery
Jong Yun Won, Kook Nam Han, You Jin Jang, Hyun Koo Kim
No abstract text is available yet for this article.
March 18, 2019: Interactive Cardiovascular and Thoracic Surgery
Jeroen Sonck, Yosuke Miyazaki, Carlos Collet, Yoshinobu Onuma, Taku Asano, Kuniaki Takahashi, Norihiro Kogame, Yuki Katagiri, Rodrigo Modolo, Patrick W Serruys, Antonio L Bartorelli, Daniele Andreini, Torsten Doenst, Juan Pablo Maureira, Andre Plass, Mark La Meir, Giulio Pompillio
OBJECTIVES: Invasive coronary angiography has been the preferred diagnostic method to guide the decision-making process between coronary artery bypass grafting (CABG) and percutaneous coronary intervention and plan a surgical revascularization procedure. Guidelines recommend a heart team approach and assessment of coronary artery disease (CAD) complexity, objectively quantified by the anatomical SYNTAX score. Coronary computed tomography angiography (CCTA) and CT-derived fractional flow reserve (FFRCT) are emerging technologies in the diagnosis of stable CAD...
March 18, 2019: Interactive Cardiovascular and Thoracic Surgery
Satoshi Asada, Masaaki Yamagishi, Keiichi Itatani, Yoshinobu Maeda, Satoshi Taniguchi, Shuhei Fujita, Hisayuki Hongu, Hitoshi Yaku
OBJECTIVES: The ideal configuration of a reconstructed aortic arch in the Norwood procedure for hypoplastic left heart syndrome is still a matter of debate. Chimney reconstruction was developed to avoid postoperative complications and turbulent flow in the aortic arch. This study sought to clarify early outcomes of the procedure and verify its haemodynamic advantages using computational fluid dynamics (CFD). METHODS: Fourteen consecutive patients with hypoplastic left heart syndrome or a variant who underwent chimney reconstruction in the Norwood procedure between January 2013 and March 2018 were enrolled...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Markus Bongert, Johannes Gehron, Marius Geller, Andreas Böning, Philippe Grieshaber
OBJECTIVES: Limb ischaemia during extracorporeal life support (ECLS) using femoral artery cannulation is frequently observed even in patients with regular vessel diameters and without peripheral arterial occlusive disease. We investigated underlying pathomechanisms using a virtual fluid-mechanical simulation of the human circulation. METHODS: A life-sized model of the human aorta and major vascular branches was virtualized using 3-dimensional segmentation software (Mimics, Materialise)...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Amedeo Anselmi, Erwan Flecher, Guillaume Leurent, Jean-Philippe Verhoye
In the case illustrated in this study, a heart transplant recipient received percutaneous mitral edge-to-edge for secondary mitral regurgitation on the basis of increased reoperative risk. After development of mitral endocarditis, reoperation and mitral valve replacement were successfully performed through the HeartPort technique. We discuss the technical aspects, including the positioning of the Intraclude® device and the access to the mitral valve in this context. We address the decision-making issues (role of minimally invasive surgery to reduce operative risk in patients with one or more previous sternotomies)...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Marisa Gasparini, Shruti Jayakumar, Sarah Ayton, Marco N Nardini, Joel D Dunning
OBJECTIVES: There has been declining interest in cardiothoracic surgery amongst medical graduates. This survey examines the exposure of British medical students to cardiothoracic surgery in various settings and its relationship with students' interest in the speciality. METHODS: A questionnaire composed of 14 quantitative and qualitative items was distributed amongst 162 medical students. The survey included questions on demographics, interest in cardiothoracic surgery, mechanisms of exposure to the speciality and desire to pursue a career in cardiothoracic surgery before and after exposure...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Emilie C Risom, Katrine B Buggeskov, Ulla B Mogensen, Martin Sundskard, Jann Mortensen, Hanne B Ravn
OBJECTIVES: Although reduced lung function and chronic obstructive pulmonary disease (COPD) is associated with higher risk of death following cardiac surgery, preoperative spirometry is not performed routinely. The aim of this study was to investigate the relationship between preoperative lung function and postoperative complications in all comers for cardiac surgery irrespective of smoking or COPD history. METHODS: Preoperative spirometry was performed in elective adult cardiac surgery patients...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Shruti Jayakumar, Marisa Gasparini, Tom Treasure, Clare Burdett
OBJECTIVES: Conduits used in coronary artery bypass grafting may have significant impact on outcomes, but evidence is mixed and there is large variation in practice. This study provides insights into the opinions of the UK surgeons on conduit use and their decision-making processes. METHODS: A questionnaire was created using the Ottawa Decision Support Framework to elicit the importance that surgeons placed on bilateral internal mammary artery grafting, skeletonization, total arterial revascularization and sequential anastomoses on a scale of 1-10...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Kunal Bhakhri, Sara Volpi, Davide Gori, Martin Goddard, Jason M Ali, Ravi De Silva
OBJECTIVES: Diffuse cardiac amyloidosis is a significant diagnosis with a poor prognosis. Isolated atrial amyloidosis (IAA) is the most common form of cardiac amyloidosis caused by accumulation of alpha-atrial natriuretic peptide. IAA has been associated with dysrhythmia, but otherwise remains a poorly characterized condition. The impact of incidental IAA on postoperative outcome following cardiac surgery has not previously been reported. The purpose of this study was to examine the impact of isolated atrial amyloid on patient outcomes following cardiac surgery...
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Joel M Sternbach, Kathleen S Berfield, Douglas E Wood
No abstract text is available yet for this article.
March 15, 2019: Interactive Cardiovascular and Thoracic Surgery
Hélène Hergault, Gauthier Mouillet, Julien Ternacle, Eric Bergoend
The risk of coronary artery injury during valve surgery is higher in case of anomalous coronary artery origin and trajectory. Unlike previous reports on coronary obstruction related to aortic or mitral surgery, we report the first case, to the best of our knowledge, of an anomalous left circumflex artery occlusion after tricuspid valve repair, and its successful percutaneous treatment.
March 11, 2019: Interactive Cardiovascular and Thoracic Surgery
Vinci Naruka, Marco Nardini, James McVie, Joel Dunning
Autologous bone graft is used in the treatment of fracture non-unions. A novel approach to treat painful manubriosternal non-unions is described with bone graft harvested from the femur and plating.
March 8, 2019: Interactive Cardiovascular and Thoracic Surgery
Claudinei Collatusso, João Gabriel Roderjan, Lucia de Noronha, Allyson Klosowski, Paula Hansen Suss, Luiz César Guarita-Souza, Francisco Diniz Affonso da Costa
OBJECTIVES: Decellularization is an alternative method for processing biological tissues with decreased antigenicity and resistance to calcification. The aim of this study was to characterize the properties of decellularized (dCell) bovine pericardium fixed with 0.1% glutaraldehyde (GA) and to evaluate outcomes of bioprosthetic valves constructed with this tissue when implanted in the mitral position of juvenile sheep. METHODS: Bioprosthetic mitral valves were constructed with fresh bovine pericardium fixed in 0...
March 8, 2019: Interactive Cardiovascular and Thoracic Surgery
Stefano Urso, Eliú Nogales, Jesús María González, Rafael Sadaba, María Ángeles Tena, Raquel Bellot, Luis Ríos, Francisco Portela
The lack of benefit in terms of mid-term survival and the increase in the risk of sternal wound complications published in a recent randomized controlled trial have raised concerns about the use of bilateral internal thoracic artery (BITA) in myocardial revascularization surgery. For this reason, we decided to explore the current evidence available on the subject by carrying out a meta-analysis of propensity score-matched studies comparing BITA versus single internal thoracic artery (SITA). PubMed, EMBASE and Google Scholar were searched for propensity score-matched studies comparing BITA versus SITA...
March 8, 2019: Interactive Cardiovascular and Thoracic Surgery
Derrick Y Tam, Andrew Tran, Amine Mazine, Gilbert H L Tang, Mario F L Gaudino, Antonio M Calafiore, Jan O Friedrich, Stephen E Fremes
OBJECTIVES: The surgical management of tricuspid regurgitation (TR) at the time of mitral valve surgery remains controversial. Our objectives were to determine the safety and efficacy of tricuspid valve (TV) repair during mitral valve surgery in a meta-analysis. METHODS: MEDLINE and EMBASE were searched from 1946 to 2017 for all studies comparing TV repair to no intervention at the time of mitral valve surgery on early and late mortality and late TR. A random-effects meta-analysis of all outcomes was performed...
March 8, 2019: Interactive Cardiovascular and Thoracic Surgery
Beatriz Rodríguez-Cubillo, Manuel Carnero-Alcázar, Javier Cobiella-Carnicer, Antolina Rodríguez-Moreno, Ali Alswies, Mercedes Velo-Plaza, Daniel Pérez-Camargo, Ana Sánchez Fructuoso, Luis Maroto-Castellanos
OBJECTIVES: We investigated the impact of acute kidney failure after a heart valve procedure among patients with or without chronic kidney disease (CKD). METHODS: All patients who had undergone a surgical valve procedure between 2005 and 2017 at our institution were divided into 2 groups depending on whether they had previous history of CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2) or not. Homogeneous groups were obtained by propensity score matching...
March 7, 2019: Interactive Cardiovascular and Thoracic Surgery
Masahide Isowa, Satoshi Ueda, Makoto Sonobe, Hiroshi Date
This is a case of type 1 congenital pulmonary airway malformation in the left lower lobe of a 26-year-old male. At the age of 1 year, he developed a pulmonary cystic lesion, which was considered to be bronchopulmonary sequestration. He grew up healthy and showed no impairment during exercise; however, giant bullous lesion development along with compressed left upper lobe and mediastinum was recently noted; consequently, the patient was referred to our hospital for further examination. We diagnosed congenital pulmonary airway malformation and performed left lower lobectomy...
March 7, 2019: Interactive Cardiovascular and Thoracic Surgery
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