The Annals of thoracic surgery
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In this article, we assessed the pooled sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in studies during the last 10 years that have solely used EBUS-TBNA as a minimally invasive technique, with or without computed tomography or positron-emission tomography screening. The meta-analysis included 1,066 patients from 9 studies who underwent EBUS-TBNA. ⋯ It has excellent sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. EBUS-TBNA is well tolerated and does not lead to complications in patients.
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Meta Analysis
Meta-analysis of patients taking statins before revascularization and aortic valve surgery.
Statin intake before cardiac surgery is associated with favorable outcomes. We sought to analyze the evidence for statin pretreatment before isolated coronary artery bypass graft surgery and aortic valve replacement surgery. In this meta-analysis, we demonstrate beneficial results for the endpoints mortality, stroke, atrial fibrillation, and length of stay in hospital in 36,053 statin-pretreated coronary artery bypass graft surgery patients compared with control subjects retrieved from 32 studies, but fail to detect relevant advantages through preoperative statin therapy for 3,091 patients undergoing aortic valve replacement from four trials. Strict adherence to guidelines recommending statin treatment before CABG surgery is therefore mandatory.
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Randomized Controlled Trial
Does external pleural suction reduce prolonged air leak after lung resection? Results from the AirINTrial after 500 randomized cases.
External pleural suction is used after lung resection to promote lung expansion and minimize air leak duration. Published randomized trials failed to prove this advantage but they are limited in number and underpowered in many cases. The aim of the AirINTrial study was to test the hypothesis that external pleural suction may reduce the rate of prolonged air leak in a large, randomized cohort. ⋯ Results from the AirINTrial showed that the routine use of external suction reduces the rate of prolonged air leak after anatomic lung resection. More accurate strategies of pleural suction based on the amount of air flow and the degree of lung expansion should be probably established to improve its effectiveness.
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Comparative Study
Comparative effects of ventricular assist device and extracorporeal membrane oxygenation on renal function in pediatric heart failure.
Effects of mechanical cardiac support on renal function in children with end-stage heart failure are unknown. The objective of this study was to investigate the impact of ventricular assist device (VAD) and extracorporeal membrane oxygenation (ECMO) on renal function in children. ⋯ On the basis of these data, we demonstrate that renal dysfunction improves early after mechanical cardiac support.
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Comparative Study
Gender differences in long-term survival of Medicare beneficiaries undergoing mitral valve operations.
Gender disparities in outcomes have been documented in cardiac surgery. Gender differences in long-term survival after mitral valve operations, especially in the elderly, are less well studied. ⋯ In this large comparative study of gender differences in mitral valve operations, elderly women had higher operative mortality and lower long-term survival. These differences appeared to be driven largely because women present for mitral valve operations later in the disease process. Mitral repair appeared to restore normal life expectancy for men but not for women. Future studies should examine the factors that influence physician referral to mitral valve operations for men and women.