The Annals of thoracic surgery
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Benign metastasizing leiomyoma (BML) is a rare cause of pulmonary nodules that occurs when uterine leiomyomas metastasize to the lung. The management of these lesions varies from resection and hysterectomy to nonsurgical treatments such as hormonal therapy. We report a case of a 45-year-old woman with multiple nodules of the right lung identified during preoperative imaging before her hysterectomy for uterine fibroids.
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Comparative Study
Impact of timing and surgical approach on outcomes after mitral valve regurgitation operations.
This study investigated whether the timing of mitral valve (MV) repair or surgical approach affects outcomes in patients with MV regurgitation. ⋯ MV repair in patients with severe MV regurgitation should be performed before New York Heart Association class III to IV symptoms develop. Minimally invasive MV repair techniques render similar outcomes as the sternotomy approach.
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Comparative Study
Total arch replacement with stented elephant trunk technique for acute type B aortic dissection involving the aortic arch.
Optimal management of patients with acute type aortic dissection is not clear. The clinical experience with total arch replacement combined with stented elephant trunk technique in the treatment of acute type B aortic dissection involving the aortic arch was analyzed. ⋯ Total arch replacement combined with stented elephant trunk technique was safe and feasible for acute type B aortic dissection involving the aortic arch. A low rate of morbidity and mortality and a satisfactory 5-year survival rate were achieved, as well as improved thrombosis of the false lumen.
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Comparative Study
20-year experience of prolonged extracorporeal membrane oxygenation in critically ill children with cardiac or pulmonary failure.
Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for life-threatening respiratory or circulatory failure. Although outcomes are favorable with short-term ECMO therapy, data on the outcomes of prolonged ECMO therapy in children are very limited. This study aimed to study morbidity and mortality associated with prolonged ECMO therapy (≥28 days) in children with refractory cardiac or pulmonary failure. ⋯ This case series highlights that the prolonged use of ECMO in children with refractory cardiac failure, respiratory failure, or both is associated with low survival. Furthermore, it suggests that the survivors of prolonged ECMO runs have significant long-term sequelae.
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Comparative Study
What is the best strategy for brain protection in patients undergoing aortic arch surgery? A single center experience of 636 patients.
Cerebral protection during aortic arch surgery can be performed using various surgical strategies. We retrospectively analyzed our results of different brain protection modalities during aortic arch surgery. ⋯ Antegrade cerebral perfusion is associated with significantly less neurologic complications than RCP and DHCA, despite longer circulatory arrest times. Medium-term survival is worse for patients with postoperative permanent neurologic deficit and preoperative type A aortic dissection.