The Annals of thoracic surgery
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Lung transplantation (LTx) benefit for survival in cystic fibrosis (CF) patients placed on the wait list is not well studied. ⋯ The benefit of LTx in adults with CF was significant at a lower baseline FEV1 than expected. A threshold for baseline FVC was established below which LTx was protective.
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Acute respiratory distress syndrome (ARDS) is a life-threatening medical condition. Extracorporeal membrane oxygenation (ECMO) is a salvage therapy for patients with ARDS and refractory hypoxia. This study compared the characteristics and outcomes of ARDS patients who did or did not receive ECMO matched with Acute Physiology and Chronic Health Evaluation II (APACHE II) score and age. ⋯ Patients with ARDS who received ECMO treatment had higher inhospital survival rates than did those with a similar disease severity and at a similar age who did not receive ECMO.
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Lung transplantation in patients older than 65 years is increasingly common, but questions remain regarding risk vs benefit and procedure choice. We identified short-term and long-term outcomes in older single-lung transplant (SLT) and bilateral-lung transplant (BLT) recipients. ⋯ Lung transplant can be offered to select older patients up to age 74 with acceptable outcomes. SLT may be preferred for elderly patients, but BLT offers acceptable long-term outcomes without significant short-term risk. Patients older than 75 have acceptable short-term outcomes for SLT, but long-term outcomes for SLT and BLT in this group are poor.
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One anatomic variant of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals (PA/VSD/MAPCAs) is characterized by the absence of intrapericardial pulmonary arteries. This anatomy obviates the possibility of incorporating the pulmonary arteries for reconstruction or palliative procedures. The purpose of this study was to evaluate the surgical results in patients undergoing repair of PA/VSD/MAPCAs with absent pulmonary arteries. ⋯ The majority of patients with PA/VSD/MAPCAs and absent pulmonary arteries can undergo complete single-stage repair with satisfactory postoperative hemodynamics. These results suggest that unifocalization of MAPCAs can provide a reasonable pulmonary vascular bed in the absence of intrapericardial pulmonary arteries.