The Annals of thoracic surgery
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Calcifying fibrous pseudotumor is an uncommon benign lesion that has unique histologic features. We report a case of calcifying fibrous pseudotumor of the pleura occurring in a 31-year-old woman. ⋯ The tumor showed dense hyalinized collagenous tissue interspersed with spindle cells, psammomatous calcifications, and a predominantly lymphoplasmocytic infiltrate. Most spindle cells were diffusely positive for vimentin, focally positive for CD34, and negative for desmins, smooth muscle actin, S-100 protein, and anaplastic lymphoma kinase-1.
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There is rising evidence that anemia and blood transfusion increase perioperative mortality in cancer patients. Patients who are treated with neoadjuvant chemotherapy with a curative intent are exposed to toxicity that may negatively affect their future outcome. ⋯ Preoperative chemotherapy for locally advanced esophagogastric cancer induces anemia and therefore leads to preoperative blood supplementation in a considerable number of patients. Data indicate that this may counteract the beneficial effects of neoadjuvant treatment.
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Early and midterm clinical and echocardiographic results after mitral valve (MV) surgery for chronic ischemic mitral regurgitation were investigated to evaluate the validity of the criteria for repair or replacement applied by us. ⋯ Correction of chronic ischemic mitral regurgitation through either repair or replacement provides a good 5-year survival rate, with more than 75% of the survivors in New York Heart Association classes I and II.
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The outcome in patients treated by conventional coronary artery bypass grafting (CABG) for coronary artery disease is negatively influenced by the presence of diabetes. The relative effect of diabetes in patients undergoing isolated minimally invasive revascularization of the left anterior descending artery (LAD) using the internal thoracic artery (ITA) has as yet not specifically been looked at. Thus, this study sought to evaluate the impact of diabetes on mid-term outcome following minimally invasive coronary artery bypass grafting (MIDCAB). ⋯ The results support diabetes to be an independent risk factor for outcome in patients with MVD undergoing a MIDCAB procedure in analogy to those undergoing CABG procedures. Diabetics with isolated disease of the LAD, however, benefit out of proportion from this treatment modality.
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Comparative Study
Use of a pH-stat strategy during retrograde cerebral perfusion improves cerebral perfusion and tissue oxygenation.
Although it is well documented that the use of a pH-stat strategy during hypothermic cardiopulmonary bypass improves cerebral blood flow, an alpha-stat strategy has been almost exclusively used during retrograde cerebral perfusion. We investigated the effects of pH-stat and alpha-stat management on brain tissue blood flow and oxygenation during retrograde cerebral perfusion in a porcine model to determine if the use of a pH-stat strategy during retrograde cerebral perfusion improves brain tissue perfusion. ⋯ In our pig model, the use of a pH-stat strategy during retrograde cerebral perfusion significantly improves brain tissue perfusion. Therefore, to improve retrograde cerebral blood flow during retrograde cerebral perfusion, it may be preferable to use a pH-stat strategy, rather than an alpha-stat strategy.