The Annals of thoracic surgery
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Comparative Study
Comparison of three measurements on computed tomography for the prediction of less invasiveness in patients with clinical stage I non-small cell lung cancer.
A greater proportion of ground-glass opacity (GGO) is well known to be strongly associated with less invasive lung adenocarcinoma. Recently, the solid area diameter has also been reported to be a simple and better marker for the same purpose compared with the whole nodule diameter. ⋯ Proportion of GGO remains important for predicting less invasive lung cancer.
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A 51-year-old man with severe mitral regurgitation was admitted. While undergoing preoperative examination for mitral disease, he was found to have absence of the right superior vena cava and a persistent left superior vena cava. ⋯ There were no difficulties during the operation. Isolated persistent left superior vena cava is very rare, but if it is diagnosed preoperatively and an appropriate operative plan is made, MICS can be performed safely.
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Comparative Study
Comparison of cardiothoracic training curricula: integrated six-year versus traditional programs.
Traditionally, cardiothoracic residency programs are 2 or 3 years in length and require the completion of a general surgery residency. Six-year integrated programs (IP) that directly match fourth-year medical students have been recently developed. Our objective was to examine the curricula of traditional 2-year (T2) and 3-year (T3) programs and compare them to the curricula of IP. ⋯ Integrated programs should not be considered "cardiac pathways" as they spend a significant amount of time on thoracic rotations. Additional nonsurgical rotations provide an opportunity for residents in IP to develop unique skills not currently provided in traditional programs.
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Interventricular septal hematoma is a very rare complication after congenital heart surgery. We report our experience with 2 cases; 1 unsuccessful attempt in a child with a ventricular septal defect and 1 successful palliation in a child with tetralogy of Fallot. On comparison with previously reported results, children seem to have better outcomes than adults. While the first choice for a hemodynamically unstable patient is surgical revision, individualized therapy should also be considered.
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Case Reports
Reoperative transapical aortic valve implantation for early structural valve deterioration of a SAPIEN XT valve.
We report on the first repeat transapical aortic "valve-in-valve" implantation for severe aortic stenosis in a degenerated transcatheter valve (Edwards SAPIEN XT; Edwards Lifesciences, Irvine, CA) using a second Edwards SAPIEN XT valve.