The Annals of thoracic surgery
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Extracorporeal membrane oxygenation (ECMO) to support cardiopulmonary resuscitation (CPR) has been shown to improve survival in children and adults. We describe outcomes after the use of ECMO to support CPR (E-CPR) in adults using multiinstitutional data from the Extracorporeal Life Support Organization (ELSO) registry. ⋯ The use of E-CPR was associated with survival in 27% of adults with cardiac arrest facing imminent mortality. Further studies are warranted to evaluate and better define patients who may benefit from E-CPR.
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Case Reports
Silicone y-stent placement on the carina between bronchus to the right upper lobe and bronchus intermedius.
Airway stenting using a silicone stent has become widespread for the palliation of airway stenosis. We often encounter patients with tumors involving the carina between the bronchus to the right upper lobe and bronchus intermedius. ⋯ We report three cases of malignant disease inserted with a Y-stent so that the bronchial limbs of the stent saddle the involved carina between the bronchus to the right upper lobe and bronchus intermedius. The respiratory symptoms improved immediately after the procedure.
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We performed thoracoscopic surgery for pneumothorax using two-lung ventilation with low tidal volume and evaluated the feasibility and safety of this procedure. ⋯ Thoracoscopic surgery for primary spontaneous pneumothorax using two-lung ventilation with low tidal volume was technically feasible.
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Hybrid revascularization has been used in minimally invasive coronary artery bypass grafting and percutaneous coronary intervention for multivessel coronary artery disease (CAD). Very few endoscopic robotic coronary bypasses on the beating heart have been reported. The aim of this study was to assess hybrid revascularization by endoscopic robotic coronary artery bypass on the beating heart with percutaneous coronary intervention in a staged approach. ⋯ Our preliminary study shows that hybrid coronary revascularization by endoscopic robotic coronary artery bypass grafting on a beating heart and subsequent stent placement is a feasible integrated approach for patients with multivessel CAD.
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Primary graft dysfunction (PGD) after lung transplantation is a major cause of morbidity and mortality. Venovenous or venoarterial extracorporeal membrane oxygenation (ECMO) allows lung recovery; however, the optimal approach and impact on long-term survival are unknown. We analyzed outcomes after ECMO use for PGD after lung transplantation at a single center over a 15-year period and assessed long-term survival. ⋯ Extracorporeal membrane oxygenation can provide acceptable support for PGD irrespective of the method used. Long-term survival of patients with primary graft dysfunction requiring ECMO (overall and weaned) was inferior to that of patients who did not require ECMO.