The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Comparative StudyDouble-bar application decreases postoperative pain after the Nuss procedure.
This biomechanical study aims to elucidate whether additional bar application increases postoperative pain after the Nuss procedure for pectus excavatum. ⋯ Performing double-bar placement decreases postoperative pain. Therefore, surgeons should not hesitate to perform double-bar correction in patients in whom the deformity extends to multiple intercostal spaces, requiring correction of the thorax shape at multiple sites.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Endovascular repair of aortic arch lesions in high-risk patients or after previous aortic surgery: midterm results.
The aim of this study was to assess the short- and midterm results after endovascular repair of the aortic arch in high-risk patients or after previous aortic surgery. ⋯ Hybrid endovascular aortic arch reconstructions, although some of these adjunctive procedures remain major operations, provide attractive alternatives for treating aortic arch lesions in high-risk patients who would otherwise be unsuitable for open repair, with acceptable primary results and encouraging midterm efficacy to prevent rupture.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Risk factor analysis for postoperative acute respiratory distress syndrome and early mortality after pneumonectomy: the predictive value of preoperative lung perfusion distribution.
This study aims to establish the preoperative risk factors in the development of acute respiratory distress syndrome (ARDS) and early mortality after pneumonectomy for lung cancer and to examine the influence of reduced pulmonary perfusion on outcomes. ⋯ Patients with a low ppo-FEV(1), a high perfusion fraction of resected lung, or both had a higher incidence of ARDS and early mortality after pneumonectomy. Therefore, although the ppo-FEV(1) appears to be within an acceptable limit for pneumonectomy, much attention should be given to patients with a high perfusion fraction of resected lung.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Chronologic changes in P-wave characteristics after the Fontan procedure: the effect of surgical modification.
The Fontan-type procedure has undergone 2 major modifications, including intra-atrial baffling and extracardiac conduit. To clarify the effect of these modifications on arrhythmia propensity, we analyzed chronologic changes in P-wave characteristics after atriopulmonary connection, intra-atrial baffling, or extracardiac conduit. ⋯ After intra-atrial baffling, patients increasingly had prolonged P-wave duration and larger dispersion associated with sinus node dysfunction, suggesting a propensity to arrhythmia, although less progressive than seen in those undergoing atriopulmonary connection. In contrast, despite an equal prevalence of sinus node dysfunction after extracardiac conduit, the lack of important changes in P-wave characteristics over time suggests that the extracardiac conduit procedure is the preferred option for optimal rhythm prognosis.