The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Chronic obstructive pulmonary disease severity influences outcomes after off-pump coronary artery bypass.
To analyze the impact and severity of chronic obstructive pulmonary disease (COPD) on pulmonary function and postoperative clinical outcome based on the Global Initiative for Obstructive Lung Disease criteria in patients undergoing off-pump coronary artery bypass grafting (CABG). ⋯ More severe COPD was associated with greater impairment in pulmonary function and worse clinical outcomes after off-pump CABG surgery. A preoperative FEV1 <50% of predicted value appears to be an important predictor of postoperative complications.
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Meta Analysis Comparative StudyAdjunct retrograde cerebral perfusion provides superior outcomes compared with hypothermic circulatory arrest alone: A meta-analysis.
Retrograde cerebral perfusion is becoming less frequently used as a method of neuroprotection during aortic surgery. The present meta-analysis aims to compare outcomes after arch surgery with hypothermic circulatory arrest versus hypothermic circulatory arrest + retrograde cerebral perfusion. ⋯ These results suggest that the addition of retrograde cerebral perfusion during aortic arch surgery may provide better outcomes than using hypothermic circulatory arrest alone, although significant confounders exist. Further robust studies are required to confirm the utility of retrograde cerebral perfusion in arch surgery.
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Randomized Controlled Trial Comparative StudyProspective, randomized, controlled trial of polymer cable ties versus standard wire closure of midline sternotomy.
Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. ⋯ ZIPFIX sternal cable ties provide reliable closure but no demonstrable benefit in this study in pain or analgesic requirements relative to standard wire closure after median sternotomy.
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J. Thorac. Cardiovasc. Surg. · Oct 2018
Multicenter StudyEffect of virtual-assisted lung mapping in acquisition of surgical margins in sublobar lung resection.
Virtual-assisted lung mapping is a preoperative bronchoscopic multi-spot dye-marking technique. This study aimed to examine the efficacy of virtual-assisted lung mapping for obtaining sufficient surgical margins in sublobar lung resection. ⋯ This study showed that virtual-assisted lung mapping has reasonable efficacy, although the successful resection rate did not reach the primary goal. The depth of the required margin was the most significant factor leading to resection failure.