The Annals of thoracic surgery
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The purpose of this study was to identify predictors of postoperative respiratory failure after surgical tracheoplasty for congenital tracheal stenosis. ⋯ Surgical treatment of congenital tracheal stenosis in neonates and infants portends a good outcome. Bronchial mismatch greater than 20% can identify a subset of patients at increased risk for surgical reintervention and chronic respiratory failure. Slide tracheoplasty with preemptive bronchial reconstruction may prevent postoperative respiratory failure.
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Persistent air leak can complicate pulmonary resection, and one management option is dismissal with a chest tube in place. This study evaluated the rate of empyema and readmission after dismissal with a chest tube. ⋯ Dismissal with an indwelling chest tube is not without consequence, having significant risk for further complications and potential need for additional interventions.
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This study reports trends in volume and adverse events associated with isolated aortic valve procedures performed in Medicare beneficiaries between 2009 and 2015. ⋯ The total number of Medicare beneficiaries undergoing isolated aortic valve procedures increased from 47.5 to 88.9 per 100,000 Medicare beneficiaries during the study period. Aortic valve procedures increased significantly during this study period primarily due to the increase in TAVR, with clinical outcomes improving as well. Although long-term outcomes of TAVR are still under investigation, these results are promising.
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After pediatric heart operations, we sought to determine the incidence of unplanned cardiac reinterventions during the same hospitalization, assess risk factors for these reinterventions, and explore associations between reinterventions and outcomes. We hypothesized that younger patients undergoing more complex operations would be at greater risk for unplanned cardiac reinterventions and that operative mortality and postoperative length of stay (PLOS) would be greater in patients who undergo reintervention than in those who do not. ⋯ Unplanned cardiac reinterventions are not rare, particularly in neonates, and are independently associated with operative mortality and increased PLOS. Patients at greater risk may be identified preoperatively, presenting opportunities for quality improvement.
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Nomogram for Predicting the Risk of Invasive Pulmonary Adenocarcinoma for Pure Ground-Glass Nodules.
The pure ground-glass nodule is a common clinical concern. The purpose of this study was to develop a nomogram to predict the risk of invasive pulmonary adenocarcinoma in patients with pure ground-glass nodules 1 cm or less in diameter based on the computed tomography imaging features. ⋯ We constructed a novel nomogram that can predict the risk of invasive pulmonary adenocarcinoma for patients with pure ground-glass nodules 1 cm or less in diameter. With highly accurate, excellent calibration and discrimination of the model, clinicians could more precisely make a specific treatment strategy for each patient.