The Annals of thoracic surgery
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Multicenter Study Comparative Study
A new method to predict postoperative lung function: quantitative breath sound measurements.
Currently, predicted postoperative (PPO) lung function (forced expiratory volume in 1 second [PPO-FEV(1)] and diffusion capacity of the lung for carbon monoxide [PPO-Dlco]) estimated from spirometry and regional perfusion is used to select patients for lung resection. Vibration response imaging (VRI) analyzes lung sounds and quantifies regional acoustic energy. Single-center studies suggest that this noninvasive, radiation-free method of quantifying lung function is comparable to the reference standard. ⋯ VRI may offer a simple, noninvasive, and radiation-free alternative to lung scintigraphy for predicting postoperative lung function in patients with lung malignancies.
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As many as 20% of patients undergoing cardiac surgery will have acute respiratory distress syndrome during the perioperative period, with a mortality as high as 80%. If patients at risk can be identified, preventative measures can be taken and may improve outcomes. ⋯ Careful fluid management, minimization of blood product transfusion, appropriate nutrition, and early physical rehabilitation may improve outcomes. In cases of refractory hypoxemia, rescue therapies such as recruitment maneuvers, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation may preserve life.
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Randomized Controlled Trial Comparative Study
Randomized trial of carpentier-edwards supraannular prosthesis versus mosaic aortic prosthesis: 6 year results.
This study prospectively compares the clinical performance of 2 stented porcine aortic bioprostheses: the Carpentier-Edwards supraannular aortic valve (CE-SAV) from Edwards Lifesciences (Irvine, CA) and the Mosaic valve from Medtronic Corp (Minneapolis, MN). We believe it is the only study of this kind. ⋯ There were no statistically significant differences in the clinical performance between CE-SAV and Mosaic aortic prostheses at 6 years after implantation.
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Comparative Study
Reoperation after acute type a aortic dissection repair: a series of 104 patients.
Our objective was to analyze the causes, timing, and results of reoperation after primary repair for acute type A dissection. ⋯ More extensive acute dissection repair results in a lower rate of reoperation. Mortality for redo surgery after type A acute dissection repair is acceptable. This finding should be taken into account in proposing a widespread of more complex and extensive surgery for type A acute dissection.
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Comparative Study
Recoarctation after the norwood I procedure for hypoplastic left heart syndrome: incidence, risk factors, and treatment options.
Early survival after the Norwood I procedure has improved over the years, but subsequent morbidity is not yet well assessed. The aim of this study was to review the incidence of recoarctation, evaluate risk factors, and analyze treatment options. ⋯ A standardized surgical technique for reconstruction of the aorta leads to a low recoarctation rate. Balloon angioplasty can be performed in the majority of patients before the second-stage procedure.