The Annals of thoracic surgery
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Untreated severe chronic thromboembolic pulmonary hypertension has a poor prognosis ending with right heart decompensation and multiorgan failure. This case report demonstrates that it is possible to intervene in the terminal stages of chronic thromboembolic pulmonary hypertension and bridge patients to surgery and recovery using various forms of extracorporeal membrane oxygenation support.
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Historical Article
Suturing of penetrating wounds to the heart in the nineteenth century: the beginnings of heart surgery.
The beginnings of cardiac surgery go back to the 19th century. This article describes the history of the first attempts to operate on the heart. In 1882, Dr Block from Danzig, and in 1895, Simplicio Del Vecchio, published reports of animal experiments showing that the suturing of heart wounds is possible. ⋯ Shortly afterward, Antonio Parrozzani successfully sutured a stab wound of the left ventricle. Following cardiac surgery back to its very beginnings, it is striking that the first attempts in the 19th century to repair the injured heart were regarded with great skepticism, and that heart suturing only slowly became an established method of treatment. Once the concept of cardiac surgery had become accepted, however, many kinds of operations were developed, paving the way for an explosion in the number of cardiac operations, as we well know, in the century that followed.
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Comparative Study
Survival after surgery for pathologic stage IA non-small cell lung cancer associated with idiopathic pulmonary fibrosis.
Many problems exist in regard to the treatment of lung cancer patients with idiopathic pulmonary fibrosis (IPF), but few reported studies have investigated the long-term prognosis after pulmonary resection in such patients. The purpose of the present study was to determine the postoperative survival of patients with pathologic stage IA non-small cell lung cancer (NSCLC) and IPF. ⋯ The 5-year survival rate of patients with pathologic stage IA NSCLC and IPF is 54.2%. IPF has independent, adverse effects on survival of pathologic stage IA NSCLC patients treated with pulmonary resection.
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There are few data to predict the benefit of pulmonary metastasectomy in patients with extrathoracic sarcoma. This study analyzes prognostic factors associated with improved outcomes. ⋯ Pulmonary metastasectomy for sarcoma can be associated with prolonged survival. Tumor resectability, DFI, number of metastases, and laterality are important factors in determining patient selection for curative surgical intervention. Repeated pulmonary metastasectomy in select patients may improve survival despite recurrent disease.
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Postoperative low cardiac output syndrome (LCOS) is associated with high morbidity and mortality after coronary artery bypass grafting (CABG). We sought to examine trends in predictors of LCOS after isolated CABG. ⋯ The impact of LVEF less than 0.20 on development of postoperative LCOS has increased markedly in the latest era of our study. Prudent preoperative evaluation in patients with severe left ventricular dysfunction is critical. Further innovative research in myocardial protection and circulatory support is warranted in patients with severe left ventricular dysfunction.