The Annals of thoracic surgery
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Case Reports
Biventricular continuous flow VADs demonstrate diurnal flow variation and lead to end-organ recovery.
HeartWare continuous flow ventricular assist devices (HVAD) configured as biventricular assist devices maintain diurnal flow variation, lead to end-organ recovery, and provide for a successful bridge-to-heart transplantation in the first successful North American use of continuous flow biventricular assist devices.
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Multicenter Study Comparative Study
Efficacy of mediastinal lymph node dissection during lobectomy for lung cancer by thoracoscopy and thoracotomy.
Mediastinal lymph node dissection (MLND) is an integral component of complete resection for non-small cell lung cancer (NSCLC). This study analyzed the National Comprehensive Cancer Network's (NCCN) NSCLC Database to compare the efficacy of MLND during lobectomy by video-assisted thoracoscopy surgery (VATS) and thoracotomy (open). ⋯ The NCCN database indicates at least three MLN stations were assessed in most patients who underwent lobectomy by either approach. As evaluated by the number of LN stations, there was no difference in the efficacy of MLN dissection by approach.
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This report describes 2 symptomatic patients with phrenic nerve palsy due to Parsonage-Turner syndrome who were managed by diaphragmatic plication. The characteristics of the underlying syndrome are defined.
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Comparative Study
Ross root dilation in adult patients: is preoperative aortic insufficiency associated with increased late autograft reoperation?
The Ross aortic valve replacement (AVR) offers excellent hemodynamic and clinical outcomes in most patients undergoing aortic root replacement. Because of ongoing debate regarding the durability of this procedure, long-term follow-up in a large adult Ross experience might be of interest. ⋯ Preoperative aortic regurgitation was not a significant risk factor for late autograft reoperation in adults. The Ross AVR provides excellent hemodynamics and survival for adults willing to accept a small risk of reoperation as opposed to a life-long risk of thromboemboli and anticoagulation therapy as exist with mechanical aortic prostheses. Reoperation risk for Ross AVR has decreased with Ross annulus sinotubular junction reinforcement replacement of a dilated ascending aorta and postoperative hypertension management.
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Comparative Study
The right internal thoracic artery: the forgotten conduit--5,766 patients and 991 angiograms.
The right internal thoracic artery (RITA) is biologically identical to the left ITA, yet is rarely used in coronary artery bypass graft surgery (CABG). We examined the results and long-term patency of RITA grafts. ⋯ Late patencies of RITA are excellent, equivalent to the LITA for identical territories, always better than radial arteries and saphenous vein grafts, and remain free of atheroma. Use of RITA in addition to LITA is associated with excellent survival in triple-vessel coronary disease. More extensive use of the RITA in CABG is recommended.