The Annals of thoracic surgery
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There is only limited information on the clinical impact of combined pulmonary fibrosis and emphysema (CPFE) on postoperative and survival outcomes among patients with resected lung cancer. ⋯ Among patients with resected lung cancer, the presence of TSCT-determined CPFE might predict worse postoperative and survival outcomes.
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We report obstruction of an anomalous right coronary artery traversing between the pulmonary artery and aorta after placement of a 21-mm bovine bioprosthesis for critical aortic stenosis requiring emergency revascularization. Although this anomaly has been associated with sudden death syndrome, acute coronary ischemia resulting from aortic valve replacement in patients with anomalous coronary artery has not been sufficiently highlighted in the literature. Awareness of this issue may decrease the risk of this complication in patients with anomalous coronary anatomy undergoing aortic or pulmonary valve replacement. Furthermore, the need for careful preoperative imaging in patients undergoing semilunar valve replacement is essential.
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Multicenter Study
Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis.
The objective of this study was to evaluate outcomes of minimally invasive approaches to esophagectomy using population-level data. ⋯ The use of minimally invasive techniques to perform esophagectomy for esophageal cancer is associated with modestly improved perioperative outcomes without compromising survival.
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Multicenter Study
Seminal Postoperative Complications and Mode of Death After Pediatric Cardiac Surgical Procedures.
Understanding the seminal complications leading to death after pediatric cardiac surgical procedures may provide opportunities to reduce mortality. This study analyzed all deaths at two pediatric cardiac surgical programs and developed a method to identify the seminal complications and modes of death. ⋯ Seminal complications occurred early postoperatively, and systemic circulatory failure was the most common mode of death. Our classification system is likely scalable for subsequent multicenter analysis to understand cause-specific mortality variation across hospitals and to drive quality improvement.
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Heparin is the main anticoagulant used during extracorporeal membrane oxygenation (ECMO) support. Nafamostat mesilate, a synthetic serine protease inhibitor, has seen increased use as a substitute for heparin in patients undergoing ECMO because of its short half-life. We aimed to compare these 2 anticoagulants with respect to bleeding and thromboembolic complications during ECMO support. ⋯ Nafamostat mesilate was found to increase the bleeding risk in patients receiving venoarterial ECMO. Regarding thromboembolic complications, there was no significant difference between heparin and nafamostat. Only old age increased the thromboembolic risk.