The Annals of thoracic surgery
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A multiinstitutional study was conducted to analyze prognosticators of completely resected and pathologic T3 N0 M0 (pT3 N0 M0) stage thymic epithelial tumors. ⋯ Postoperative radiotherapy was associated with improved survival in patients with pT3 N0 M0 thymic epithelial tumors. Lung invasion was associated with poor survival in patients with pT3 N0 M0 thymoma. Adjuvant chemotherapy was associated with improved survival in patients with pT3 N0 M0 thymic carcinoma with superior vena cava or innominate vein invasion.
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Previous work has identified that inpatient post-thoracic surgery chest x-ray films (CXR) are overutilized. ⋯ Implementation of our quality improvement initiative safely and systematically reduced empiric CXR use after inpatient thoracic surgery. Results will be used in future quality improvement initiatives to reduce unnecessary postoperative testing.
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Herein we described a novel repair approach for a left atrial esophageal fistula. Complete mediastinal debridement and simultaneous primary repairs of the left atrial posterior wall and the esophagus were completed under a median sternotomy, central cardiopulmonary bypass, left atrial circular incision around four pulmonary veins, inflamed left atrial posterior wall removal, and posterior pericardial opening.
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Minimally invasive direct coronary artery bypass (MIDCAB) is a well-established, low-impact surgical procedure for revascularization of the left descending coronary artery with the left internal mammary artery. This study aimed to evaluate safety, overall survival, and freedom from major adverse cardiocerebral-related events (MACCE) after 20 years of MIDCAB. ⋯ The very long-term clinical outcome of MIDCAB is satisfactory in terms of survival and freedom from MACCE. MIDCAB significantly reduces hospital length of stay and blood transfusions when compared with full sternotomy bypass surgery on the left descending coronary artery and appears to improve prognosis in terms of cardiac-related events and all-cause events effectively.
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The presence of significant atrioventricular valve (AVV) regurgitation results in unfavorable conditions that affect the success of single-ventricle (SV) multistage palliation. We report our institution's AVV repair experience. ⋯ AVV repair at the first-stage operation and reduced systemic ventricle function are associated with poor outcomes. In those high-risk patients, different approaches that involve initial palliation mode, timing of AVV repair, or listing for transplantation might be warranted.