The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2017
WebcastsPulmonary artery sealing with ultrasonic energy in open lobectomy: A phase I clinical trial.
Pulmonary artery branch sealing in video-assisted thoracoscopic surgical lobectomy is usually achieved with vascular endostaplers. Iatrogenic pulmonary artery injury may be caused by endostaplers. We evaluated the safety of pulmonary artery sealing with an ultrasonic energy vessel-sealing device in a phase I clinical trial evaluating in vivo safety of the device during open lobectomy. ⋯ Pulmonary artery sealing for vessels with diameter ≤7 mm was safely achieved with an ultrasonic energy vessel-sealing device in open lobectomy. The use of ultrasonic energy vessel-sealing devices in video-assisted thoracoscopic surgical lobectomy may have the advantage of making small, short, pulmonary artery branch sealing safer than with vascular endostaplers. Further studies are necessary before widespread application in lobectomy, including video-assisted thoracoscopic surgical lobectomy.
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J. Thorac. Cardiovasc. Surg. · Jun 2017
Editorial CommentTeaching congenital heart disease: A new era?
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J. Thorac. Cardiovasc. Surg. · Jun 2017
Comparative StudyComparison of right ventricle-pulmonary artery shunt position in the Single Ventricle Reconstruction trial.
Placement of a right ventricle-pulmonary artery shunt to the left or right of the neoaorta may influence reinterventions, pulmonary artery development, and survival after the Norwood procedure because of differences in shunt and pulmonary artery geometry and blood flow. ⋯ In the Single Ventricle Reconstruction trial, right ventricle-pulmonary artery shunt placement to the right of the neoaorta was associated with fewer shunt revisions and may contribute to improved outcomes in select patients.
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J. Thorac. Cardiovasc. Surg. · Jun 2017
Causes of death from the randomized CoreValve US Pivotal High-Risk Trial.
Explore causes and timing of death from the CoreValve US Pivotal High-Risk Trial. ⋯ Mortality at 1 year in the CoreValve US Pivotal High-Risk Trial favored TAVR over SAVR. The major contributor was that more SAVR patients died during the recovery period (31-121 days), likely affected by the overall influence of physical stress associated with surgery. Similar rates of technical failure and complications were observed between the 2 groups. This suggests that early TAVR results can improve with technical refinements and that high-risk surgical patients will benefit from reducing complications.
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J. Thorac. Cardiovasc. Surg. · Jun 2017
WebcastsIntraoperative electromagnetic navigational bronchoscopic localization of small, deep, or subsolid pulmonary nodules.
Localizing small or deep pulmonary nodules or subsolid ground-glass opacities often is difficult during video-assisted thoracoscopic surgery (VATS) or robotic-assisted thoracoscopic surgery (RATS). This can result in larger resections or conversion to thoracotomy. The goal of this study is to evaluate the role of electromagnetic navigational bronchoscopic localization (ENBL) as a safe and accurate intraoperative method to localize small, deep, or subsolid nodules. ⋯ ENBL is a safe and accurate intraoperative modality for targeted sublobar resection of pulmonary nodules that are deemed difficult to localize.