The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Multicenter StudyCognitive outcomes and health-related quality of life in adults two decades after the arterial switch operation for transposition of the great arteries.
The study objective was to evaluate the cognitive and psychosocial outcomes of young adults who underwent an arterial switch operation for transposition of the great arteries. ⋯ Despite satisfactory outcomes in most adults with transposition of the great arteries, a substantial proportion has cognitive or psychologic difficulties that may reduce their academic success and quality of life. Further studies are needed to better understand the long-term outcome of this population to provide prevention, surveillance, and care strategies.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Clinical TrialA novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer.
To investigate safety and feasibility of navigational bronchoscopy (NB)-guided near-infrared (NIR) localization of small, ill-defined lung lesions and sentinel lymph nodes (SLN) for accurate staging in patients with non-small cell lung cancer (NSCLC). ⋯ NB-guided NIR lesion localization and SLN identification was safe and feasible. This minimally invasive image-guided technique may permit the accurate localization and nodal staging of early stage lung cancers.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Observational StudyImpaired cerebral autoregulation in preoperative newborn infants with congenital heart disease.
To characterize cerebral autoregulation (CA) in preoperative newborn infants with congenital heart disease (CHD). ⋯ Term newborns with CHD display time-varying CA abnormalities. Associations seen between abnormal CA and greater FTOE, lack of sedation, and lower hemoglobin suggest that impaired oxygen delivery and increased cerebral metabolic demand may overwhelm autoregulatory capacity in these infants. Further studies are needed to determine the significance of impaired CA in this population.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Comparative StudyThe Cox-Maze IV procedure for atrial fibrillation is equally efficacious in patients with rheumatic and degenerative mitral valve disease.
To determine whether the etiology of mitral valve disease (MVD), due to either rheumatic or degenerative pathology, influences long-term outcomes after the Cox-Maze IV procedure (CMPIV). ⋯ The long-term efficacy of the CMPIV in restoring sinus rhythm was similar in patients with either rheumatic or degenerative mitral valve disease. Despite representing a sicker patient population with a longer duration of preoperative AF, patients with rheumatic MVD equally benefit from the CMPIV.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Secondary sclerosing cholangitis in cardiac surgical patients: A complication with a dismal prognosis.
Secondary sclerosing cholangitis in critically ill patients is a rapidly progressing disease leading to biliary fibrosis and cirrhosis. We describe the course of sclerosing cholangitis in critically ill patients after cardiac surgery and compare this with matched patients. ⋯ Sclerosing cholangitis in critically ill patients is a fatal complication in patients undergoing cardiac surgery who have a complicated postoperative course with prolonged vasoconstrictor, inotropic, and respiratory therapy, or who require frequent surgical revisions. Liver transplantation remains the only curative option but is often precluded by the age and critical state of patients undergoing cardiac surgery.