The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Postoperative atrial fibrillation is associated with increased morbidity and resource utilization after left ventricular assist device placement.
Postoperative atrial fibrillation (POAF) is a known risk factor for morbidity and mortality after cardiac surgery but has not been investigated in the left ventricular assist device (LVAD) population. We hypothesize that POAF will increase morbidity and resource utilization after LVAD placement. ⋯ POAF was associated with increased major morbidity, possibly from worsening right heart failure leading to increased renal failure and unplanned right ventricular assist device placement. This led to patients with POAF having longer intensive care unit and hospital stays and more frequent discharges to a facility.
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Comparative Study Observational StudyModification of expanded polytetrafluoroethylene valved conduit using the thin-type leaflets.
The expanded polytetrafluoroethylene conduit with fan-shaped leaflets and bulging sinuses for right ventricular outflow tract reconstruction was modified with a newly developed thin-type expanded polytetrafluoroethylene leaflet. The purpose of this study was to evaluate the clinical outcomes and hemodynamic performance of the modified conduit. ⋯ Although the clinical outcomes did not differ within midterm observation, the thin-type expanded polytetrafluoroethylene leaflet was considered to be suitable for the small-sized conduits, but not for large-sized conduits, based on the comparison of the hemodynamic performance. Long-term follow-up is necessary to address the appropriate sheet type for middle-sized conduits and to estimate the durability of the thin-type leaflet.
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Tricuspid valvular dynamics and 3-dimensional geometry in awake and anesthetized sheep.
Clinical and experimental tricuspid valve physiology data are derived predominantly from anesthetized subjects, but normal tricuspid valve geometry and dynamics may be altered by general anesthesia and mechanical ventilation. We set out to investigate 3-dimensional geometry and dynamics of the tricuspid valve complex in awake and anesthetized sheep. ⋯ General anesthesia did not alter tricuspid annular or subvalvular 3-dimensional geometry but reduced right ventricular contraction and tricuspid annular dynamics.
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Computed tomography features of resected lung adenocarcinomas with spread through air spaces.
Spread through air spaces (STAS) is a recently recognized invasive pattern of lung cancer defined as "micropapillary clusters, solid nests, or single cells beyond the edge of the tumor into air spaces." Since STAS has been shown to be a significant prognosticator for the postoperative survival, predicting STAS preoperatively by computed tomography (CT) might help determine the optimum surgical procedures. ⋯ The presence of notch and the absence of GGO were independently associated with the STAS phenomenon. These results will prove helpful in identifying STAS-positive adenocarcinoma by CT before surgical resection.
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Early acute respiratory distress syndrome after pneumonectomy: Presentation, management, and short- and long-term outcomes.
Postpneumonectomy acute respiratory failure leading to invasive mechanical ventilation carries a severe prognosis, especially when acute respiratory distress syndrome develops. The aim of this study was to describe the risk factors, management, and outcome of postpneumonectomy acute respiratory distress syndrome. ⋯ Acute respiratory distress syndrome is a severe early complication of pneumonectomy with a poor outcome. The low survival underlines the need for novel management strategies.