The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2013
Randomized Controlled TrialTen-year outcomes of patients randomized to surgery, angioplasty, or medical treatment for stable multivessel coronary disease: effect of age in the Medicine, Angioplasty, or Surgery Study II trial.
With progressive aging, coronary artery disease has been diagnosed at more advanced ages. Although patients aged 65 years or more have been referred to surgical or percutaneous coronary interventions, the best option for coronary artery disease treatment remains uncertain. The current study compared the 3 treatment options for coronary artery disease in patients aged 65 years or more and analyzed the impact of age in treatment options. ⋯ In this analysis, treatment options for patients aged 65 years or more who have coronary artery disease yield similar overall survival. However, coronary artery bypass grafting was associated with fewer coronary events, and percutaneous coronary intervention was associated with a higher incidence of myocardial infarction.
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J. Thorac. Cardiovasc. Surg. · Nov 2013
Randomized Controlled Trial Comparative StudyThe impact of tidal volume on pulmonary complications following minimally invasive esophagectomy: a randomized and controlled study.
Minimally invasive esophagectomy (MIE) has been advantageous for lowering pulmonary complications compared with open approaches.(1) However, pulmonary complications remain the most common morbidity after surgical resection of esophageal cancer.(2,3) The aim of this prospective, randomized, controlled, clinical trial was designed to see whether low tidal volume (VT) could further minimize pulmonary complications after MIE. ⋯ Lung injury due to intraoperative single-lung ventilation may contribute to pulmonary complications after MIE. Low VT ventilation could decrease ventilation-associated lung inflammation, thus minimizing pulmonary complications after MIE. Further studies, based on a larger volume of populations, are required to confirm these findings.
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J. Thorac. Cardiovasc. Surg. · Nov 2013
Prevalence of lymph node metastases in superficial esophageal squamous cell carcinoma.
Endoscopic treatment of superficial esophageal carcinoma has been increasingly conducted around the world. Because no lymph nodes are removed in such a procedure, the risk of lymph node metastases (LNMs) should be clearly understood. The aim of the present study was to accurately clarify the pattern of lymphatic spread in patients with superficial esophageal squamous cell carcinoma and analyze the factors potentially related to LNMs. ⋯ Endoscopic treatment can be attempted when the tumor is limited to the lamina propria mucosa. However, 2-field radical lymphadenectomy with careful upper mediastinal lymph node resection should be conducted for submucosal squamous cell carcinoma.
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J. Thorac. Cardiovasc. Surg. · Nov 2013
Case Reports Comparative StudyVirtual endobronchial ultrasound for transbronchial needle aspiration.
Endobronchial ultrasound-guided transbronchial needle aspiration could be performed better with computer-based preparation. ⋯ Both computer-based preparation methods of virtual endobronchial ultrasound were useful in predetermining the puncture spot of transbronchial needle aspiration, suggesting their potential complementary role to the conventional technique of endobronchial ultrasound-guided transbronchial needle aspiration.
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J. Thorac. Cardiovasc. Surg. · Nov 2013
Comparative StudyImpact of ABO compatibility on outcomes after heart transplantation in a national cohort during the past decade.
Immunologic incompatibility has implications for primary graft failure, rejection, and survival in heart transplantation. To our knowledge, this is the first large cohort study investigating the impact of ABO-compatible versus identical blood type matching on post heart transplantation survival. ⋯ ABO-compatible transplantation does not result in adverse outcomes with respect to graft survival. Blood type O donor grafts, however, were associated with decreased survival. This has important implications for current graft allocation policies, particularly for type B recipients.