The Annals of thoracic surgery
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Bronchopleural fistula (BPF) is an uncommon and potentially fatal complication of lobectomy or pneumonectomy, particularly in tuberculosis patients. It is associated with high mortality and its treatment remains a challenge. ⋯ Follow-up over 10 months revealed maintenance of the repair without any recurrence. This novel technique can be effective for treating a tuberculosis patient with postoperative BPF.
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Randomized Controlled Trial Multicenter Study Comparative Study
Results of low-dose carperitide infusion in high-risk patients undergoing coronary artery bypass grafting.
This study investigated the efficacy of human atrial natriuretic peptide (hANP, carperitide) for high-risk patients undergoing coronary artery bypass grafting (CABG). ⋯ In the early postoperative period, carperitide has a cardiorenal protective effect that prevents postoperative MACCE and hemodialysis. Perioperative low-dose carperitide infusion may be useful in high-risk patients undergoing on-pump CABG.
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Randomized Controlled Trial Comparative Study
The no-touch saphenous vein as the preferred second conduit for coronary artery bypass grafting.
Injury incurred while saphenous veins are being obtained results in poor graft patency and impairs the results of coronary artery bypass grafting. A novel method of obtaining veins, the no-touch technique, has shown improved long-term saphenous vein graft patency. ⋯ No-touch saphenous vein grafts showed a significantly higher patency rate than the radial artery grafts and the patency was comparable to the patency for left internal thoracic artery grafts. This highlights the improvement in saphenous vein graft quality with the no-touch technique and increases the number of situations in which saphenous veins may be preferable to radial artery grafts as conduits in coronary artery bypass grafting.
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Comparative Study
In-hospital shunt occlusion in infants undergoing a modified blalock-taussig shunt.
The clinical variables leading to postoperative thrombotic occlusion of a modified Blalock-Taussig shunt (mBTS) remain elusive. In this investigation, we assess several perioperative variables to determine associations with postoperative in-hospital shunt occlusion. ⋯ We found that a patient's anatomy (pulmonary atresia/ventricular septal defect with or without major aortopulmonary collateral arteries) and the size of the pulmonary artery being shunted had a significant impact in predicting postoperative in-hospital shunt occlusion. These results emphasize that technical skills and a low resistance to blood flow are necessary for successful shunt function. Although some perioperative coagulation values were significantly reduced in infants who were destined to experience shunt occlusion, they would be difficult to detect clinically.
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Comparative Study
Dilatation of the remaining aorta after aortic valve or aortic root replacement in patients with bicuspid aortic valve: a 5-year follow-up.
The natural history and management of ascending aorta (AA) and arch dilatation in patients with bicuspid aortic valve (BAV) after aortic valve replacement (AVR) or aortic root replacement (ARR) remains controversial. Our aim is to identify dilatation of the remaining aorta after AVR or ARR in patients with BAV compared with patients with tricuspid aortic valve (TAV). ⋯ No significant dilatation of the AA or arch was observed after AVR or ARR, respectively, in patients when a cut-off diameter of 4.5 cm or greater was considered for replacement in patients with BAV compared with patients with TAV up to 5 years after operation. The need for aortic replacement at smaller diameters was not found.