The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative StudyPrognostic value of intraoperative pleural lavage cytology for non-small cell lung cancer: the influence of positive pleural lavage cytology results on T classification.
Although positive pleural lavage cytology (PLC) has been demonstrated to be closely associated with a poor prognosis for patients with lung cancer, it has not been incorporated into the TNM staging system of the Union for International Cancer Control. The aim of our study was to retrospectively examine the clinical significance of PLC status and illustrate the recommendations of the International Pleural Lavage Cytology Collaborators (IPLCC) in a large national database. ⋯ Our results indicate that a T category upgrade is prognostically adequate for patients who are PLC-positive.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative Study Observational StudySurgery of postinfarction ventricular septal rupture: the effect of David infarct exclusion versus Daggett direct septal closure on early and late outcomes.
David infarct exclusion and Daggett direct septal closure are alternative techniques to repair postinfarction ventricular septal rupture. The aim of the present study was to compare the 2 methods with regard to postoperative morbidity, 30-day mortality, and long-term survival. ⋯ David infarct exclusion was superior to Daggett direct septal closure for early and late survival after surgery for postinfarction ventricular septal rupture. Total coronary revascularization improved survival more in the David than in the Daggett group.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
A simple approach to mitral valve repair: posterior leaflet height adjustment using a partial fold of the free edge.
Multiple techniques have been used to repair degenerative mitral valve prolapse with leaflet elongation, without creating systolic anterior motion. We describe a simple, reproducible, measured technique to guide repair. ⋯ Partial fold of the posterior leaflet free edge is a simple technique to restore the normal 2:1 ratio of A2/P2 with a ring size determined by the A2 height. Using just the A2 height, mitral surgeons can reproducibly repair the posterior leaflet prolapse, choose the appropriate ring size, and avoid more complex leaflet reconstruction or judgment of the neochord length.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Acute Risk Change for Cardiothoracic Admissions to Intensive Care (ARCTIC index): a new measure of quality in cardiac surgery.
Quality of cardiac surgical care may vary between institutions. Mortality is low and large numbers are required to discriminate between hospitals. Measures other than mortality may provide better comparisons. ⋯ The ARCTIC index is associated with known markers of perioperative performance and postoperative morbidity. It may be used as an overall marker of quality for cardiac surgery. Further work is required to assess ARCTIC as a method to discriminate between cardiac surgical units.