The Annals of thoracic surgery
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Review Meta Analysis
Skeletonized internal thoracic artery harvest improves prognosis in high-risk population after coronary artery bypass surgery for good quality grafts.
Skeletonization of the internal thoracic artery is supposed to achieve extra length with added advantages of decreased sternal complications. There is no agreement whether skeletonization affects grafts, main adverse cardiac events, mortality, or pulmonary function when compared with the conventional pedicled method. The aim of our study was to determine the effectiveness and safety of different harvesting techniques. ⋯ Skeletonized harvesting for the internal thoracic artery provides superiority to the quality of grafts with additional advantages of lesser trauma, producing fewer postoperative complications. Above all, skeletonized grafting in the high-risk population has a potential benefit in mortality and mainly adverse cardiac events.
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Comparative Study
Postoperative anemia and exercise tolerance after cardiac operations in patients without transfusion: what hemoglobin level is acceptable?
Restrictive transfusion strategies have been suggested for cardiac surgical patients, leading to various degrees of postoperative anemia. This study investigates the exercise tolerance during rehabilitation of cardiac surgical patients who did not receive transfusions, with respect to their level of postoperative anemia. ⋯ Postoperative anemia with hemoglobin levels of 8 to 10 g/dL is well tolerated in patients who have not received a transfusion and induces only a transient impairment of exercise tolerance.
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Multicenter Study Comparative Study
Endoscopic management of idiopathic tracheal stenosis.
Idiopathic tracheal stenosis (ITS) is a rare condition representing a difficult therapeutic challenge. Endoscopic management is a therapeutic option but long-term results are not established. The aim of this retrospective multicenter study was to analyze long-term outcome after endoscopic management of ITS. ⋯ Endoscopic management of ITS provides a safe and efficient therapeutic option but late recurrences are frequent and require long-term follow-up.
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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.