The Annals of thoracic surgery
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We developed a novel technique for tracheobronchial reconstruction after resection of carcinoma of the right upper lung involving the right main bronchus and lower trachea. Preliminary results of the technique are reported. ⋯ Despite this being a small series and short follow-up, this tracheobronchial reconstruction shows encouraging preliminary results with low mortality and morbidity, and could be an alternative to other methods for the treatment of carefully selected patients with advanced carcinoma of the right upper lobe.
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The 3f aortic bioprosthesis is a stentless valve resembling the native aortic valve. It has been postulated that improved hemodynamic performance with this prosthesis may translate into superior durability. We hereby report the midterm results using this valve substitute. ⋯ Its unique design makes the 3f aortic bioprosthesis less complex to implant than conventional stentless valves, as only a single suture line is necessary. The hemodynamic profile and clinical performance of the prosthesis are inconsistent with the established stentless valves, especially with regard to higher incidence of neurologic complications seen during the follow-up.
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Pheochromocytoma is a catecholamine-secreting tumor associated with clinical presentations ranging from paroxysmal hypertension to intractable cardiogenic shock. We report the use of central extracorporeal life support (ECLS) in a young woman admitted to the intensive care unit with cardiogenic shock. Her medical history included neurofibromatosis type I and pheochromocytoma. ⋯ ECLS permitted full recovery of left ventricular function. Right adrenelectomy was performed 4 months later. In this case, central ECLS was used to treat pheochromocytoma-induced cardiogenic shock complicated by pulmonary edema.
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A volume-outcome association has been shown for cardiovascular procedures such as coronary artery bypass grafting. The association of a volume-outcome relationship for aortic valve replacement procedures, however, has not been clearly defined. We evaluated the influence of surgeon volume on operative outcomes with isolated aortic valve replacement and aortic valve replacement with concomitant coronary artery bypass grafting. ⋯ Surgeon volumes have a significant influence on operative outcomes in high-risk patients undergoing aortic valve replacement or aortic valve replacement with coronary artery bypass grafting.
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Tracheal stenosis after intubation is a fairly common complication, and treatment of such cases can be difficult. A 52-year-old woman was admitted to our hospital because of severe dyspnea. ⋯ In this case, tracheal restenosis had occurred and we successfully treated the patient by insertion of a silicone T-tube after tracheotomy. Use of a T-tube is safe and effective for relief of tracheal restenosis after self-expandable metal stent placement.