The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2013
Operative outcomes in mitral valve surgery: combined effect of surgeon and hospital volume in a population-based analysis.
We evaluated the combined effect of hospital and surgeon volume on operative outcomes of mitral valve surgery in the United States. ⋯ The effect of hospital volume on operative outcomes of mitral valve surgery was largely driven by the individual surgeon volumes within that hospital. Conversely, surgeon volume affected these outcomes independently of hospital volume. Identifying the processes by which higher volume surgeons attain better outcomes in mitral valve surgery would therefore be prudent.
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J. Thorac. Cardiovasc. Surg. · Sep 2013
Factors predictive of distal stent graft-induced new entry after hybrid arch elephant trunk repair with stainless steel-based device in aortic dissection.
Stent graft-induced new entry (SINE) has been increasingly observed after thoracic endovascular aortic repair of aortic dissection. We illustrate the possible mechanism by exploring predictive factors of late distal SINE after hybrid arch elephant trunk repair for aortic dissection. ⋯ We found that taper ratio is not an optimal criteria for stent graft size selection and distal oversizing calculated by true-lumen area is a significant factor causing delayed distal SINE. Use of the prestenting area oversizing ratio should be limited.
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J. Thorac. Cardiovasc. Surg. · Sep 2013
Low-fat diet management strategy for chylothorax after pulmonary resection and lymph node dissection for primary lung cancer.
We reviewed our experience of iatrogenic chylothorax after pulmonary resection for primary lung cancer to evaluate a low-fat diet management strategy. ⋯ A low-fat diet and OK-432 pleurodesis achieved positive results in >80% of patients with chylothorax after pulmonary resection with systematic mediastinal lymph node dissection within 4 weeks after the initial surgery. More than 500 mL of chylous fluid during the first 24 hours after the initiation of the low-fat diet was valid as an indication of the need for surgical intervention.
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J. Thorac. Cardiovasc. Surg. · Sep 2013
Comparative StudyVideo-assisted thoracic surgery for pulmonary sequestration compared with posterolateral thoracotomy.
Pulmonary sequestration is a rare congenital malformation of the lungs. This study aims to evaluate the effectiveness of video-assisted thoracic surgery for the treatment of pulmonary sequestration in a larger series compared with posterolateral thoracotomy. ⋯ Video-assisted thoracic surgery resection for pulmonary sequestration is feasible, although it should be performed by an experienced surgeon with awareness of the potential risk of severe vascular injury.