The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Survival outcomes in patients with primary cardiac sarcoma in the United States.
We aim to evaluate the survival outcomes of primary cardiac sarcoma in a US nationwide cancer database. ⋯ At the population level, primary cardiac sarcoma has a poor prognosis. Both surgery and chemotherapy are associated with improved survival, whereas increasing age at diagnosis was associated with worse survival.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Autogenous mitochondria transplantation for treatment of right heart failure.
Right ventricular hypertrophy and failure are major causes of cardiac morbidity and mortality. A key event in the progression to right ventricular hypertrophy and failure is cardiomyocyte apoptosis due to mitochondrial dysfunction. We sought to determine whether localized intramyocardial injection of autologous mitochondria from healthy muscle treats heart failure. ⋯ Mitochondrial transplantation allows for prolonged physiologic adaptation of the pressure-loaded right ventricular and preservation of contractility by reducing apoptotic cardiomyocyte loss.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Results of treating primary pulmonary sarcomas and pulmonary carcinosarcomas.
Primary pulmonary sarcomas (PPS) and pulmonary carcinosarcomas (PCS) are rare aggressive lung malignancies. We reviewed our 21-year experience with the surgical and nonsurgical treatment of both tumors, comparing their clinical, histopathologic, and treatment results. ⋯ At initial evaluation, PPS and PCS presented with large-sized tumors and usually were not stage I. Surgery had a positive impact on survival among patients with PPS. Whenever feasible, surgical resection, even in locally advanced disease, may yield long-term survival in these aggressive lung tumors, although the level of evidence is low.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Impact of trisomy 13 and 18 on airway anomalies and pulmonary complications after cardiac surgery.
To determine the prevalence and influence of clinically significant airway and/or respiratory abnormalities in patients with trisomy 13 and 18 undergoing cardiac surgery. ⋯ Although most trisomy 13/18 patients survive cardiac surgery, these patients have an increased incidence of airway complications, requiring longer intensive respiratory support postoperatively that contributes to longer length of stay. Parental guidance before cardiac surgery should include a discussion about postoperative airway management.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Resection and replacement of thoracic aortic graft infections.
Thoracic aortic graft infection (TAGI) presents a formidable challenge with high mortality. We evaluated our 22-year experience managing TAGI with extensive debridement, graft replacement, vascularized tissue coverage, and aggressive antibiotics. ⋯ TAGI continues to represent a highly morbid surgical challenge. Prompt antimicrobial coverage, debridement, graft replacement, and vascularized graft coverage, yielded best long-term results. Endograft infection and aortobronchial fistula had very poor prognoses.