The Annals of thoracic surgery
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Comparative Study
Surgical biopsy of suspected interstitial lung disease is superior to radiographic diagnosis.
Different modalities are used to diagnose interstitial lung disease. We compared the effectiveness of minimally invasive surgical biopsy versus high-resolution computed tomography for the diagnosis of interstitial lung disease and report the mortality of the procedure. ⋯ Surgical biopsy should remain the gold standard for diagnosis of interstitial lung disease. The mortality is low with proper patient selection. More than two surgical biopsy specimens may not be needed because the concordance rates among pathologic specimens are very high.
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Case Reports
Thoracoscopic lobectomy for synchronous intralobar pulmonary sequestration and lung cancer.
Bronchopulmonary sequestration is a rare congenital pulmonary malformation for which surgical resection is recommended, and several reports have described successful resection by video-assisted thoracoscopic surgery. Coexistence of sequestration with lung malignancy is extremely rare. We report the first case of thoracoscopic resection of synchronous intralobar pulmonary sequestration and non-small cell lung cancer.
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Postoperative bleeding is common after cardiac surgery. Major bleeding (MB) is a determinant of red blood cell (RBC) transfusion, especially in patients with preoperative anemia. Preoperative anemia and RBC transfusions are recognized risk factors for operative mortality. The present study investigates the role of MB as an independent determinant of operative mortality in cardiac surgery. ⋯ Major bleeding is per se a risk factor for operative mortality. However, its deleterious effects are strongly enhanced by RBC transfusions and, to a lesser extent, preoperative anemia. Major bleeding is a partially modifiable risk factor, and adequate preemptive and treatment strategies should be applied to limit this event.
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Incidence of thrombosis in neonates undergoing cardiac surgery is as high as 20%, and single ventricle physiology (SVP) may present an even higher risk. We hypothesize that SVP is a risk factor for thrombosis in neonates undergoing cardiac surgery, and hypercoagulability biomarkers are predictive of postoperative thrombosis. ⋯ Single ventricle physiology patients are at higher risk for thrombosis compared with other neonates after cardiac surgery. Hypercoagulable panel testing may help risk stratify patients and guide patient specific anticoagulation management in the postoperative period.
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We evaluated the current results and the predictors of in-hospital complications for a pericardiectomy procedure for constrictive pericarditis in Japan. ⋯ Pericardiectomy is associated with high morbidity and mortality rates. Careful consideration should be given to these risk factors in the process of patient selection and perioperative management.