The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2022
Mapping the collateral network: Optimal near-infrared spectroscopy optode placement.
Paraplegia after extensive aortic procedures is a disastrous complication, and maintenance of adequate spinal cord perfusion/oxygenation is pivotal to its prevention. Collateral network (CN) near-infrared spectroscopy (cnNIRS) has been introduced as a noninvasive method for indirect spinal cord oxygenation monitoring. However, the CN has not been investigated in its entirety using this monitoring modality. This study aimed to identify the optimal cnNIRS positioning in an acute large animal model for routine clinical use. ⋯ cnNIRS is capable of detecting relevant changes during ischemia and reperfusion from the mid-thoracic level downward with characteristic oxygenation patterns corresponding to CN and spinal cord regional perfusion. For extensive aortic procedures, noninvasive cnNIRS placement appears to be useful from the mid-thoracic level (T7-T9) to the lower lumbar level (L3-L5) and also may serve as a versatile monitoring method for procedures limited to the proximal thoracic aorta.
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J. Thorac. Cardiovasc. Surg. · Jul 2022
Stepwise external wrapping procedure for type A intramural hematoma.
The optimal treatment for Stanford type A acute intramural hematoma remains controversial, especially in elderly or high-risk patients. ⋯ Our stepwise external wrapping is a feasible alternative to conventional graft replacement for high-risk patients with type A intramural hematoma. The early and midterm outcomes of the procedure were satisfactory, but further careful follow-up is needed.
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J. Thorac. Cardiovasc. Surg. · Jul 2022
Preoperative renal dysfunction and long-term survival after surgery for non-small cell lung cancer.
To investigate the association of preoperative renal dysfunction and long-term outcomes following lung cancer surgery. ⋯ Preoperative renal dysfunction may be adversely associated with overall survival after lung cancer surgery. Our findings could aid patients to set proper expectation of the risks and benefits about surgery for lung cancer.
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J. Thorac. Cardiovasc. Surg. · Jul 2022
Outcomes of aortic valve repair in children resulting in bicuspid anatomy: Is there a need for tricuspidization?
We aimed to assess outcomes after aortic valve repair leading to bicuspid valve anatomy in children. ⋯ Aortic valve repair leading to bicuspid valve anatomy in children has satisfactory long-term results. Reoperation remains common, but the need for early valve replacement can be effectively delayed.