The Annals of thoracic surgery
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Postoperative atrial fibrillation (POAF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization. A significant association between circulating osteoprotegerin concentration and atrial fibrillation incidence had been identified. Osteoprotegerin/receptor activator of nuclear factor-κB/receptor activator of nuclear factor-κB ligand (RANKL) axis may also contribute to the development and progression of AF. Herein we sought to determine whether preoperative serum soluble RANKL and osteoprotegerin and soluble RANKL/osteoprotegerin ratio are associated with the incidence of POAF in cardiac surgery patients. ⋯ Elevated preoperative serum soluble RANKL level and soluble RANKL/osteoprotegerin ratio are independent predictors for POAF in patients undergoing cardiac valve surgery. These findings have important implications for identifying patients at higher risk of POAF who could be considered for prophylactic therapy.
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Comparative Study
The Aristotle score predicts mortality after surgery of patent ductus arteriosus in preterm infants.
Outcomes after surgical ligation of patent ductus arteriosus (PDA) in preterm infants are often complicated by prematurity associated comorbidities. The Aristotle comprehensive complexity score (ACCS) has been proposed as a useful tool for complexity adjustment in the analysis of outcome after congenital heart surgery. The aims of this study were to define preoperative risk factors for mortality and to demonstrate the usefulness of ACCS to predict mortality after surgical ligation of PDA in the preterm. ⋯ The ACCS, especially for procedure-independent complexity factors, is a useful tool to predict mortality after ligation of PDA in preterm infants.
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This study was undertaken to compare clinicopathologic features and survival between patients with unexpected N1 (clinical N0-pathologic N1) and expected N1 disease (clinical N1-pathologic N1) after operation for non-small cell lung cancer. ⋯ Patients with unexpected N1 disease showed better survival than did those with expected N1 disease, which seemed to be related to the pathologically minimal extent of the primary tumor and nodal involvement.
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Catheter-based ablation for atrial fibrillation (AF) performed percutaneously is shown to be limited in patients with nonparoxysmal AF (non-PAF). The full Cox-Maze surgical procedure demonstrated good success with non-PAF, but concerns were raised regarding increased morbidity eliminating the effect of the success rate. This study assessed the safety and efficacy of a stand-alone on-pump Cox-Maze procedure for non-PAF. ⋯ The long-term success rate after the Cox-Maze III procedure in a challenging group of non-PAF patients is acceptable. Our experience suggests the development of educational strategies to overcome the initial learning curve and patient selection criteria for AF surgical ablation.
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Intraoperative localization of ground-glass opacities is difficult because they are not easy to palpate and may be invisible at radioscopy. Therefore, various techniques have been developed to improve intraoperative localization of these lesions, allowing an adequate surgical resection. The aim of this study is to report two cases of preoperative localization of ground-glass opacities through computed tomography-guided placement of a metallic clip inside the lesion and to discuss this new technique in comparison with those previously described.