The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2011
Randomized Controlled TrialStandardized preoperative corticosteroid treatment in neonates undergoing cardiac surgery: results from a randomized trial.
A heightened inflammatory response occurs after cardiac surgery. The perioperative use of glucocorticoids has been advocated as a method to improve postoperative outcomes. Randomized prospective studies to quantify the effect of methylprednisolone on perioperative outcomes in neonatal cardiac surgery have not been performed. We sought to determine whether preoperative methylprednisolone would improve postoperative recovery in neonates requiring cardiac surgery. ⋯ Combined preoperative and intraoperative use of glucocorticoids in neonatal cardiac surgery does not favorably affect early clinical outcomes and may exacerbate perioperative renal dysfunction.
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J. Thorac. Cardiovasc. Surg. · Dec 2011
Anatomic repair for congenitally corrected transposition of the great arteries: a single-institution 19-year experience.
Anatomic repair for congenitally corrected transposition of the great arteries (ccTGA) has been shown to improve patient survival. We sought to examine long-term outcomes in patients after anatomic repair with focus on results in high-risk patients, the fate of the neo-aortic valve, and occurrence of morphologically left ventricular dysfunction. ⋯ There is significant morbidity after anatomic repair of ccTGA, which is higher in the DS than the RS group. Nevertheless, the majority of patients are free of heart failure at 10 years, including high-risk patients in severe heart failure before repair. Aortic annuloplasty may reduce risk of late aortic insufficiency.
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J. Thorac. Cardiovasc. Surg. · Dec 2011
Comparative Study Controlled Clinical TrialA prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer.
The study objective was to compare endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with mediastinoscopy for mediastinal lymph node staging of potentially resectable non-small cell lung cancer. ⋯ EBUS-TBNA and mediastinoscopy achieve similar results for the mediastinal staging of lung cancer. As performed in this study, EBUS-TBNA can replace mediastinoscopy in patients with potentially resectable non-small cell lung cancer.
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J. Thorac. Cardiovasc. Surg. · Dec 2011
Video-assisted thoracoscopic surgery (VATS) lobectomy: catastrophic intraoperative complications.
Large case series have demonstrated that video-assisted thoracoscopic surgery (VATS) lobectomy is feasible and safe. However, catastrophic intraoperative complications during VATS lobectomy requiring thoracotomy can be overlooked and are not reported in the current literature. We reviewed our experience to determine the frequency, management, and outcome of these complications. ⋯ Catastrophic intraoperative complications of VATS lobectomy are uncommon. However, awareness of the possibility of such injuries is critical to avoid them, and development of specific management strategies is necessary to limit morbidity should they occur.