The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Cerebral near-infrared spectroscopy insensitively detects low cerebral venous oxygen saturations after stage 1 palliation.
Measurement of cerebral venous oxyhemoglobin saturation (ScvO2) is considered a gold standard in assessing the adequacy of tissue oxygen delivery (DO2) after the stage 1 palliation (S1P), with SvO2 <30% often representing severely compromised DO2. Regional oxygenation index (rSO2) based on near-infrared resonance spectroscopy (NIRS) frequently is used to screen for compromised DO2, although its sensitivity to detect severe abnormalities in SvO2 is uncertain. ⋯ Cerebral rSO2 in isolation should not be used to detect low ScvO2, because its sensitivity is low, although correction of rSO2 for arterial contamination may improve sensitivity. Cerebral rSO2 of 50 or greater should not be considered reassuring, though values below 30 are specific for low ScvO2.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Reoperative aortic root replacement: Outcome in a contemporary series.
Reoperative aortic root replacement is a challenging procedure associated with significant mortality and morbidity. The purpose of this study was to investigate the outcomes of reoperative aortic root replacement when performed in a number of complex clinical settings and to identify risk factors for operative mortality and long-term survival. ⋯ Reoperative aortic root replacement represents complex procedures carrying significant morbidity and mortality. Chronic lung disease, prior myocardial infarction, and concomitant mitral valve surgery were risk factors for operative mortality. Age, peripheral artery disease, emergency, and concomitant mitral valve surgery were risk factors for long-term mortality.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Comparative StudyOutcomes after lobar versus sublobar resection for clinical stage I non-small cell lung cancer in patients with interstitial lung disease.
Since the prognosis after standard lobectomy for non-small cell lung cancer (NSCLC) in patients with interstitial lung disease (ILD) is poor, we investigated the possibility of sublobar resection for the improvement of the surgical results in such patients. ⋯ Sublobar resection may be a potential alternative choice for clinical stage I NSCLC with ILD on HRCT.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Indications for sublobar resection of clinical stage IA radiologic pure-solid lung adenocarcinoma.
The aim of this study was to identify clinical factors associated with lepidic growth in resected clinical stage IA radiologic pure-solid lung adenocarcinoma for identifying a possible sublobar resection candidate in the population. ⋯ Higher maximum standardized uptake value may be useful for identifying patients with clinical stage IA radiologic pure-solid lung adenocarcinoma in whom sublobar resection should not be considered, even if technically feasible.