The Annals of thoracic surgery
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We have developed a four-dimensional (4D) lung cancer model that forms perfusable tumor nodules. We determined if the model could be modified to mimic metastasis. ⋯ The 4D lung cancer model can isolate tumor cells in 3 phases of tumor progression. This 4D lung cancer model may mimic the biology of lung cancer metastasis and may be used to determine its mechanism and potential therapy in the future.
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Although reduction of a dilated aortic annulus is becoming an essential parameter for durable valve repair, anatomical descriptions of the annulus and surgical landmarks of the subvalvular plane for an external aortic annuloplasty remain to be defined. ⋯ External dissection of the aortic annulus allows subvalvular placement of an external aortic ring below the left and NC cusps and below or within 3 mm of the right cusp nadir in 80% of cases. An external aortic annuloplasty would induce at least a 5-mm reduction of annulus diameter, corresponding to tissue thickness. Precise anatomical landmarks are important to standardize aortic valve annuloplasty.
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Near-infrared spectroscopy (NIRS) is a noninvasive technique that allows continuous monitoring of regional hemoglobin oxygen saturation (rSo2). We evaluated its application to survey oxygenation of the spinal cord region during open thoracoabdominal aortic aneurysm (TAAA) repair and postoperatively in the intensive care unit (ICU). We also validated its association with motor-evoked potential (MEP) monitoring during the operation. ⋯ NIRS is an easily applicable noninvasive tool for continuous surveillance of oxygenation of the spinal cord region during TAAA repair and postoperatively in the intensive care unit. The rSo2 curves provide useful information concerning hemodynamic changes in oxygenation of the spinal cord region and might contribute to early detection of spinal cord ischemia. Further investigation is needed before broad clinical implementation.
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Case Reports
Thoracic endovascular aortic repair after iatrogenic aortic dissection and false lumen stent grafting.
Iatrogenic aortic dissections are a severe complication after thoracic endovascular aortic repair, and treatment guidelines do not exist. Herein, we report a patient who experienced an iatrogenic type B aortic dissection during elective thoracic endovascular aortic repair and suggest an interventional treatment option.