The Annals of thoracic surgery
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Self-expandable stents loaded with 125I (iodine 125) seeds may combine the advantages of the immediate relief of esophageal dysphagia with stent placement and radiation therapy with brachytherapy. We compared the self-expanding irradiation stent with a conventional self-expandable covered stent in patients with malignant dysphagia due to recurrent esophageal cancer. ⋯ This study indicated that the radiation stent had a potential benefit of a longer dysphagia relief period. However, no significant survival benefits were observed in the radiation stent group and the high incidence rate of massive hemorrhages further limited its application in patients with malignant dysphagia due to recurrent esophageal cancer.
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Comparative Study
Better short-term outcome by using sutureless valves: a propensity-matched score analysis.
Sutureless aortic valve prostheses have the potential of shortening ischemic time. However, whether shorter operative times may also result in improved patient outcomes and have an effect on hospital costs remains to be established. ⋯ A shorter procedural time in the sutureless group is associated with better clinical outcomes and reduced hospital costs.
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Predictive factors for red blood cell transfusion in children undergoing noncomplex cardiac surgery.
Red blood cell (RBC) transfusion is frequently required in pediatric cardiac surgery and is associated with altered outcome and increased costs. Determining which factors predict transfusion in this context will enable clinicians to adopt strategies that will reduce the risk of RBC transfusion. This study aimed to assess predictive factors associated with RBC transfusion in children undergoing low-risk cardiac surgery with cardiopulmonary bypass (CPB). ⋯ The present study identified several factors that were significantly associated with perioperative RBC transfusion. Based on these factors, we designed a predictive score that can be used to develop a patient-based blood management program with the aim of reducing the incidence of RBC transfusion.
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Thrombus straddling a patent foramen ovale, namely, a paradoxical embolus in transit, is a rarely identified entity signifying impending arterial embolism. We report a series of 3 patients with preoperatively or intraoperatively identified paradoxical embolus in transit. All patients underwent surgical evacuation and had unremarkable postoperative courses with no episodes of arterial embolization. Surgical embolectomy should be considered early in the treatment of paradoxical embolus in transit.
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Comparative Study
Short-term outcomes using magnetic sphincter augmentation versus Nissen fundoplication for medically resistant gastroesophageal reflux disease.
In 2012 the United States Food and Drug Administration approved implantation of a magnetic sphincter to augment the native reflux barrier based on single-series data. We sought to compare our initial experience with magnetic sphincter augmentation (MSA) with laparoscopic Nissen fundoplication (LNF). ⋯ MSA results in similar objective control of GERD, symptom resolution, and improved quality of life compared with LNF. MSA seems to restore a more physiologic sphincter that allows physiologic reflux, facilitates belching, and creates less bloating and flatulence. This device has the potential to allow individualized treatment of patients with GERD and increase the surgical treatment of GERD.