The Annals of thoracic surgery
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The aim of this study was to assess the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for differentiating cN0 versus cN1 non-small cell lung cancer. ⋯ Endobronchial ultrasound-guided transbronchial needle aspiration can accurately access the hilar and interlobar lymph nodes in patients with potentially resectable lung cancer. Accurate assessment of cN0 versus cN1 by EBUS-TBNA may be used to guide induction therapy before surgery.
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Small series have identified a relationship between preoperative hematocrit (HCT) and outcomes in coronary artery bypass graft (CABG) surgery. The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) began collecting preoperative HCT data in 2008. In this study, analyses were performed to determine the impact of preoperative HCT on perioperative morbidity and mortality among patients undergoing isolated CABG. ⋯ Preoperative HCT is a powerful independent predictor of perioperative mortality as well as renal failure and deep sternal wound infection in patients undergoing isolated primary CABG operations. These findings should prompt investigation of strategies to increase preoperative HCT.
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A 16-year-old adolescent boy sustained traumatic bronchopleural fistula, refractory to conventional management, which was treated successfully with differential lung ventilation and extracorporeal membrane oxygenation support. This case highlights a novel approach for managing traumatic bronchopleural fistula in children.
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Previous studies have suggested that early surgery after coronary angiography may be associated with the risk of acute kidney injury (AKI) in cardiac surgery with cardiopulmonary bypass. However, the effect of coronary angiography on the risk of AKI after off-pump coronary artery bypass graft surgery (OPCABG) remains uncertain. ⋯ The risk of postoperative AKI was not related to the time between coronary angiography and OPCABG. These findings suggest that delaying elective OPCABG after coronary angiography owing to the sole concern for renal function may be unnecessary.
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Reconstruction of anomalous left pulmonary veins (ALPV) requires an anastomosis at a nonanatomic position, posing the potential risk of pulmonary vein obstruction (PVO). ⋯ Total ALPV carries a high risk of early PVO. Thus, the optimal surgical approach remains elusive. Untreated partial ALPV remained unobstructed during midterm follow-up. Therefore, surgical treatment may not be necessary in patients with partial ALPV.