The Annals of thoracic surgery
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Case Reports
Pulmonary resection of lung cancer in a patient with partial anomalous pulmonary venous connection.
We report a case of a 64-year-old man in whom a partial anomalous pulmonary venous connection (PAPVC) was found before right lower lobectomy for lung cancer. In addition to lung cancer, there was a right superior pulmonary vein that drained into the superior vena cava (SVC). ⋯ Therefore cardiac catheterization was performed to calculate the pulmonary-to-systemic flow rate in the presence of blocked blood flow to the lower lobe pulmonary artery. As a result, we successfully performed lobectomy without correcting the PAPVC.
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Comparative Study
Delayed management of blunt traumatic aortic injury: open surgical versus endovascular repair.
A growing body of evidence has shown that delayed management of traumatic injury of the thoracic aorta determines survival benefits as compared with immediate treatment. However, few data exist comparing outcomes after delayed open surgical or endovascular management. Accordingly, we reviewed our experience with delayed management, stratifying the data according to type of repair; open surgical versus endovascular. ⋯ Delayed management of traumatic aortic injury was associated with satisfactory short- and long-term results without significant differences between open surgical and endovascular repair. However, the reduced invasiveness of endovascular repair can optimize operative timing allowing prompt aortic repair in unstable patients, earlier repair in stable patients, and, when indicated, easier concomitant non-aortic surgery.
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The role of surgical resection for stage IIIA non-small cell lung cancer (NSCLC) is unclear. We sought to examine outcomes after pneumonectomy for patients with stage IIIA disease. ⋯ Long-term survival after pneumonectomy for stage IIIA NSCLC is within an acceptable range, but pneumonectomy may not be appropriate after induction therapy or in patients with renal insufficiency. Patient selection and operative technique that limit perioperative morbidity and facilitate the use of adjuvant chemotherapy are critical to optimizing outcomes.
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The SynCardia temporary total artificial heart (t-TAH) provides complete circulatory support by replacing both native cardiac ventricles and all cardiac valves. ⋯ The SynCardia t-TAH provided acceptable survival to transplantation rates with a remarkably low incidence of neurologic events. Posttransplant survival was similar to that of patients undergoing primary heart transplantation in France.
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A 10-year-old boy was admitted with dilated cardiomyopathy. Before scheduled implantation of a HeartWare ventricular assist device, he experienced a cardiac arrest and required extracorporeal membrane oxygenation for both cardiac and pulmonary support. After 4 days of extracorporeal membrane oxygenation and 126 days of support on the HeartWare ventricular assist device, he underwent successful cardiac transplantation. He is doing well 6 months after transplantation.