The Annals of thoracic surgery
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Previous studies have suggested that early surgery after coronary angiography may be associated with the risk of acute kidney injury (AKI) in cardiac surgery with cardiopulmonary bypass. However, the effect of coronary angiography on the risk of AKI after off-pump coronary artery bypass graft surgery (OPCABG) remains uncertain. ⋯ The risk of postoperative AKI was not related to the time between coronary angiography and OPCABG. These findings suggest that delaying elective OPCABG after coronary angiography owing to the sole concern for renal function may be unnecessary.
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Randomized Controlled Trial Comparative Study
Segmentectomy versus wedge resection for non-small cell lung cancer in high-risk operable patients.
Patients with early-stage lung cancer and limited pulmonary reserve may not be appropriate candidates for lobectomy. In these situations, sublobar resection (wedge or segmentectomy) is generally performed. Many physicians believe that segmentectomy is superior because it allows for an improved parenchymal margin and nodal sampling. ⋯ In ACOSG Z4032, wedge resection, regardless of the approach, was associated with a smaller parenchymal margin and a lower yield of lymph nodes and rate of nodal upstaging when compared with segmentectomy.
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Comparative Study
Midterm results of different surgical techniques to replace dilated ascending aorta associated with bicuspid aortic valve disease.
This study evaluated effectiveness of three different surgical strategies for treating ascending aorta aneurysm, with or without involvement of the aortic root, associated with bicuspid aortic valve (BAV). ⋯ At midterm follow-up, the Bentall operation remains associated with optimal results for the treatment of BAV, despite a worse preoperative presentation. In presence of a mildly diseased or normal aortic root and normal BAV function at the time of operation, less invasive surgical procedures, BAV-sparing, or repair procedures, appear to offer gratifying results.
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The aim of this study was to assess the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for differentiating cN0 versus cN1 non-small cell lung cancer. ⋯ Endobronchial ultrasound-guided transbronchial needle aspiration can accurately access the hilar and interlobar lymph nodes in patients with potentially resectable lung cancer. Accurate assessment of cN0 versus cN1 by EBUS-TBNA may be used to guide induction therapy before surgery.
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We report a case of aortic valve replacement with a sutureless valve in a degenerated aortic homograft. This technique allows rapid aortic valve replacement in a heavily calcified aortic root. ⋯ It is particularly suitable in redo procedures for homograft degeneration. It avoids performing a redo Bentall operation with its known morbidity.