The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Observational StudyComparison of plasma to tissue DNA mutations in surgical patients with non-small cell lung cancer.
Noninvasive liquid biopsies of circulating tumor DNA (ctDNA) can be used to assess non-small cell lung cancer (NSCLC), but previous work focused on patients with advanced-stage cancer. Thus, we evaluated the feasibility and their potential clinical application of circulating tumor DNA approached for surgical patients with NSCLC. ⋯ ctDNA mutation analysis for stage I-III surgical patients with NSCLC is feasible. More studies are needed to investigate its clinical application.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
How detrimental is reexploration for bleeding after cardiac surgery?
To establish the risk factors and impact of reexploration for bleeding in a large modern cardiac surgical cohort. ⋯ Reexploration for bleeding is a lethal and morbid complication of cardiac surgery, with a detrimental effect that surpasses that of any other known potentially modifiable risk factor. All efforts should be made to minimize the incidence and burden of reexploration for bleeding, including further research on transfusion management during CPB.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Observational StudyDiagnosis of perioperative myocardial infarction after heart valve surgery with new cut-off point of high-sensitivity troponin T and new electrocardiogram or echocardiogram changes.
Criteria for diagnosing myocardial infarction (MI) after heart valve surgery are not collected in the Third Universal Definition of MI. We aimed to define cut-offs for high-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-MB (CK-MB) for the diagnosis of perioperative MI after heart valve surgery according to perioperative MI determined by new alterations in electrocardiogram (ECG) and/or transthoracic echocardiogram (TTE). Secondary endpoints were incidence of perioperative MI, postoperative complications, 30-day mortality, and 2-year survival. ⋯ Cut-offs for hs-cTnT and CK-MB to diagnose perioperative MI after heart valve surgery are well above upper reference limit. These findings update the Third Universal Definition providing cut-offs to diagnose perioperative MI after heart valve surgery.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Transcatheter aortic valve insertion after previous mitral valve operation.
There are limited data on transcatheter aortic valve insertion after previous mitral valve operation. To better understand the associated procedural risks, we reviewed our single-center experience. ⋯ Transcatheter aortic valve insertion appears to be a safe and effective operation after previous mitral valve operation. Procedure success was achieved with both balloon expandable and self-expanding devices and was independent of arterial access method. Transcatheter valve insertion should not be denied strictly on the basis of a previous mitral valve operation.
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J. Thorac. Cardiovasc. Surg. · Sep 2017
Clinical outcomes following self-expanding metal stent placement for esophageal salvage.
To assess the efficacy of self-expanding metal stents (SEMS) for esophageal salvage in patients who would otherwise require esophageal/conduit resection. ⋯ Our study demonstrates the successful use of SEMS in patients with anastomotic leaks, perforations, and recalcitrant strictures.