The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2016
Application of combined-type Y-shaped covered metallic stents for the treatment of gastrotracheal fistulas and gastrobronchial fistulas.
To determine the safety and feasibility of combined-type integrated Y-shaped self-expanding covered metallic stents to treat gastrotracheal fistulas (GTFs) and gastrobronchial fistulas (GBFs). ⋯ Deployment of the combined-type Y-shaped integrated self-expanding covered metallic stent proved to be an effective, safe, and minimally invasive procedure for complex GTFs and GBFs. Our patients tolerated the stents well and had good palliation of their symptoms.
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J. Thorac. Cardiovasc. Surg. · Aug 2016
Editorial Historical ArticleNarcissus, the Beam, and lung cancer.
In the management of lung cancer, the rules of engagement of stereotactic ablative radiotherapy (SABR) are not clearly defined. The potential for SABR to affect to an unprecedented level current protocols and in all disease stages emerges vehemently from the literature. However, in a time when the role of surgery is being reassessed, surgeons need to take a closer look at the evidence for the use of SABR in lung cancer patients and clearly define their indisputable role within the context of multidisciplinary teams. The myth of Narcissus exemplified in the absolute masterpiece by Caravaggio seems to represent an ideal metaphor to explain the ever-evolving interaction between surgery and SABR in lung cancer management.
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J. Thorac. Cardiovasc. Surg. · Aug 2016
Comparative StudyOutcomes of neonatal Ebstein's anomaly without right ventricular forward flow.
In neonates with Ebstein's anomaly and absent right ventricular forward flow, pulmonary valve morphology is normal or abnormal. Although initial postnatal presentations of these 2 conditions are similar, clinical courses and therapeutic strategies for each category differ greatly. ⋯ In patients with Ebstein's anomaly and absent right ventricular forward flow, large pulmonary valve annulus size indicated a normal pulmonary valve. Patients with a normal pulmonary valve showed better survival and had a higher probability of achieving biventricular hemodynamics.
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J. Thorac. Cardiovasc. Surg. · Aug 2016
Observational StudyPredictors of respiratory instability in neonates undergoing patient ductus arteriosus ligation after the introduction of targeted milrinone treatment.
The postoperative course of preterm babies undergoing surgical closure of a patent ductus arteriosus (PDA) is often complicated by postligation cardiac syndrome (PLCS). Despite targeted milrinone prophylaxis, some infants continue to experience postoperative respiratory deterioration. Our objective is to describe the immediate postoperative course and identify risk factors for respiratory instability when preterm infants undergoing PDA ligation are managed with targeted milrinone treatment. ⋯ Although the incidence of PLCS has declined after the introduction of targeted milrinone prophylaxis, many preterm infants continue to develop respiratory instability after surgical ligation. In this population, diastolic dysfunction manifested by prolonged IVRT could be associated with an adverse postoperative respiratory course.