The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Apr 2012
Comparative StudyOutcomes of mitral valve repair for bileaflet prolapse.
Repair of bileaflet prolapse has been considered to be technically demanding and challenging. To assess the reliability and durability of mitral valve repair for bileaflet prolapse, the present study compared the outcomes of mitral valve repair for bileaflet prolapse with those for posterior prolapse. ⋯ The reproducibility and reliability of mitral valve repair for bileaflet prolapse compares favorably with that of posterior leaflet prolapse. Early surgery might be recommended for patients with severe mitral regurgitation owing to bileaflet prolapse.
-
J. Thorac. Cardiovasc. Surg. · Apr 2012
Leukocyte-depleted blood transfusion is associated with decreased survival in resected early-stage lung cancer.
Blood transfusion has been shown to have deleterious effect on lung cancer survival, but little data are available that assess whether leukocyte-depleted (LD) blood has a similar adverse effect. Our institution has been using LD red cells since 2001. We sought to determine whether LD blood has an effect on survival after resection of early-stage lung cancer. ⋯ Our data suggest that transfusion of LD blood is associated with a worse disease-free and overall survival in patients with resected stage I non-small cell lung cancer.
-
J. Thorac. Cardiovasc. Surg. · Apr 2012
Management of systolic anterior motion after mitral valve repair: an algorithm.
To evaluate the effectiveness and outcomes of an intraoperative and postoperative algorithm for managing systolic anterior motion (SAM) after mitral valve repair (MVRr). ⋯ SAM is a relatively frequent complication after MVRr and can occur intraoperatively or postoperatively. A systematic approach addressing perioperative SAM after MVRr yields excellent mid-term results.
-
J. Thorac. Cardiovasc. Surg. · Apr 2012
Factors determining successful computed tomography-guided localization of lung nodules.
To investigate the factors related to the successful computed tomography-guided nodule localization for subsequent nodule excision. ⋯ The distance between the hook wire tip and pleural surface was the major significant factor for successful computed tomography-guided nodule localization for subsequent video-assisted thoracic surgery resection. Thus, the localization of a hook wire adjacent to a target nodule with sufficient depth from the pleural surface is crucial to the success of the procedure.
-
J. Thorac. Cardiovasc. Surg. · Apr 2012
Evolution of operative techniques and perfusion strategies for minimally invasive mitral valve repair.
Perfusion strategies and operative techniques for minimally invasive mitral valve repair have evolved over time. During the past decade, our institution's approach has progressed from a port access platform with femoral perfusion to predominantly a central aortic cannulation through a right anterior minithoracotomy incision. We analyzed this institutional experience to evaluate the impact of approach on patient outcomes. ⋯ Central aortic cannulation through a right anterior minithoracotomy for mitral valve repair allows excellent outcomes in patients with a broad spectrum of comorbidities and has become our preferred approach for most patients undergoing mitral valve repair. Retrograde arterial perfusion is associated with an increased risk of stroke in patients with severe peripheral vascular disease and should be reserved for select patients without significant atherosclerosis.