The Annals of thoracic surgery
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Restrictive mitral annuloplasty with revascularization is considered the best approach to ischemic mitral regurgitation with heart failure, but late results are controversial. We report late outcome in relation to preoperative left ventricular end-diastolic diameter (LVEDD) cutoff values, previously identified to predict intermediate-term left ventricular reverse remodeling. ⋯ At 4.3 years' follow-up, intermediate-term cutoff values for left ventricular reverse remodeling proved to be predictors for late mortality. For patients with preoperative LVEDD of 65 mm or less, restrictive mitral annuloplasty with revascularization provides a cure for ischemic mitral regurgitation and heart failure; however, when LVEDD exceeds 65 mm, outcome is poor and a ventricular approach should be considered.
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Review Comparative Study
Video-assisted thoracic surgery lobectomy (VATS), open thoracotomy, and the robot for lung cancer.
Video-assisted thoracic surgery (VATS) lobectomy provides a minimally invasive approach for the management of early-stage lung cancer. Questions about the safety of VATS lobectomy and its adequacy as a cancer operation compared with open thoracotomy have hindered its universal acceptance among thoracic surgeons. Evidence suggests that VATS lobectomy can be safely performed and is an adequate cancer operation for early-stage non-small cell lung cancer. However, adequately powered well-balanced studies comparing VATS with open thoracotomy for lobectomy are lacking in the literature.
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Randomized Controlled Trial Multicenter Study
Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: findings from PREVENT IV.
This analysis compares 1-year vein graft patency and major adverse cardiac and cerebral events (MACCE [death, myocardial infarction, or stroke]) in on-pump and off-pump patients enrolled in PREVENT IV (the PRoject of Ex-vivo Vein graft ENgineering via Transfection IV). ⋯ Observed saphenous vein failure rate was 25% in both groups. One-year clinical outcomes (MACCE) were better with off-pump than with on-pump CABG, suggesting benefits not related to vein graft patency.
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Randomized Controlled Trial
Effect of perfusion temperature on the inflammatory response during pediatric cardiac surgery.
Cardiopulmonary bypass (CPB) triggers the whole body inflammatory response, and it has been suggested that the degree of hypothermia may influence these responses. The aim of this prospective study was to compare the inflammatory response in children undergoing CPB for repair of congenital heart defects, randomized to mild or moderate hypothermia. ⋯ Only minor differences in cytokine levels were detected between those with moderate and those with mild hypothermia during CPB. Ischemic aortic cross-clamp time and time on CBP should be as short as possible to avoid an excessive inflammatory response and possibly adverse clinical effects.
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Review Case Reports
Multiple calcifying fibrous pseudotumors disseminated in the pleura.
Calcifying fibrous pseudotumor is an extremely rare benign lesion that develops in the pleura. We describe a case of multiple lesions in the pleura. The patient is a 52-year-old woman who had a subpleural mass on chest roentgenogram. ⋯ The largest tumor was hanging down from the parietal pleura, and additional small nodules were disseminated throughout the pleural cavity. Only a few tumors arising from the largest one were resected, and the others were left unresected. The resected tumors consisted of collagenous fibrous tissue, calcifications, and spindle cells that were positive only for vimentin immunostaining.