The Annals of thoracic surgery
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The early outcome after aortic arch surgery has improved. However, some operative survivors have died as a result of postoperative problems soon after discharge. This study determines the factors affecting mortality within 1 year of total arch replacement. ⋯ Total arch replacement using a branched arch graft with selective antegrade cerebral perfusion has a favorable 1-year mortality rate except for patients undergoing emergency surgery and for elderly patients.
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Case Reports
Use of recombinant factor VIIa as a rescue treatment for intractable bleeding following repeat aortic arch repair.
Hemorrhage, refractory to aggressive conventional therapy, at a rate of 16 L/hr following separation from cardiopulmonary bypass for aortic arch repair, was controlled with a dose of 90 microg/kg of recombinant factor VIIa, repeated once after 2 hours.
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Meta Analysis
Sleeve lobectomy or pneumonectomy: optimal management strategy using decision analysis techniques.
The choice between sleeve lobectomy and pneumonectomy is controversial for patients with early-stage lung cancer and who have acceptable lung function. ⋯ In patients with anatomically appropriate early-stage lung cancer, sleeve lobectomy offers better long-term survival and quality of life than does pneumonectomy and is more cost effective.
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Comparative Study
Lung resection for non-small-cell lung cancer in patients older than 70: mortality, morbidity, and late survival compared with the general population.
Operative mortality and morbidity in elderly patients operated on for non-small-cell lung cancer are acceptable. However, risk factors for hospital mortality and the benefits for the patients in the long term are insufficiently defined, and survival compared with the general population is not known. ⋯ Pulmonary resection for non-small-cell lung cancer in patients older than 70 years shows acceptable morbidity and mortality. The Charlson index is a better predictor of complications than individual risk factors. In time survival is no longer correlated with the disease but follows the same pattern as the general population.