The Annals of thoracic surgery
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At the 25th Annual General Thoracic Surgical Club meeting in March 2012, the major cooperative groups presented updates on clinical trials at the Robert Ginsberg Clinical Trials Meeting. There were 57 members in attendance. ⋯ These include oncologic trials that thoracic surgeons are currently accruing patients to in North America. The purpose of this review is to centralize the information to assist surgeons enrolling patients into oncologic clinical trials in thoracic surgery.
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Extracorporeal membrane oxygenation (ECMO) is the most common form of cardiac support for postcardiotomy cardiac failure in children. While its benefits have been thoroughly explored in infants weighing more than 3 kg, similar analyses are lacking in lower weight neonates. This single-center study investigated outcomes and risks for poor survival among infants weighing 3 kg or less. ⋯ For infants weighing 3 kg or less, 30-day survival after decannulation after cardiac ECMO is poor. Factors associated with poor prognosis were need for renal replacement therapy and longer duration of ECMO support. These findings may provide a useful guide for medical decision making among this unique, high-risk patient group.
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Loeys-Dietz syndrome can present with cardiovascular complications in infancy. We report the successful surgical management in a 1-month-old infant with Loeys-Dietz syndrome of a ductus arteriosus aneurysm with an unexpected contained rupture found at the time of surgery.
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Acute kidney injury in patients undergoing cardiac surgery and coronary angiography on the same day.
Contrast media used for coronary angiography may result in a contrast-induced nephropathy. Acute kidney injury (AKI) is a common complication of cardiac surgery. It has been hypothesized that cardiac surgery in close succession to coronary angiography may increase the risk of postoperative AKI. However, data from the existing literature are conflicting. The aim of this study is to investigate the risk of AKI in patients undergoing angiography and cardiac surgery on the same day, and to assess the efficacy of a policy limiting this practice. ⋯ Acute kidney injury after cardiac surgery is a multifactorial event; surgery on the same day of angiography significantly increases the risk of AKI, and limiting this practice results in a containment of the postoperative AKI incidence.