The Annals of thoracic surgery
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Comparative Study
Preoperative atrial fibrillation increases risk of thromboembolic events after left ventricular assist device implantation.
Because no series has specifically analyzed the impact of preoperative atrial fibrillation (AF) on patients already at higher risk of thromboembolism after implantation of a left ventricular assist device (LVAD), we review our experience with these patients. ⋯ Patients with preoperative AF have a lower freedom from TE events after LVAD implant. While overall late survival was not significantly reduced in these patients, refinement in anticoagulation strategies after VAD implant may be required.
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Comparative Study
Minimally invasive mitral valve surgery: influence of aortic clamping technique on early outcomes.
Several methods of aortic clamping have been described for minimally invasive mitral valve surgery (MIMVS). The aim of this study was to compare the endoaortic balloon occlusion technique with the transthoracic clamp approach in terms of perioperative outcomes. ⋯ Minimally invasive mitral valve surgery can be performed successfully using either the endoaortic balloon technique or the transthoracic clamp approach. However, the transthoracic technique results in shorter operation time, less perioperative bleeding and better myocardial protection.
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Comparative Study
Cerebral blood flow autoregulation is preserved after hypothermic circulatory arrest.
Patients undergoing aortic operations with hypothermic circulatory arrest (HCA) may require prolonged rewarming, a maneuver associated with impaired cerebral blood flow (CBF) autoregulation. The purpose of this study was to determine the effects of HCA on CBF autoregulation with a validated method based on near-infrared spectroscopy. ⋯ During aortic reconstructive operations, CBF autoregulation is preserved during the cooling phase of the procedure in patients undergoing HCA. Perfusion maneuvers associated with HCA may be protective against impaired autoregulation during rewarming compared with the non-HCA group.
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Comparative Study
Extended sleeve lobectomy: one more step toward avoiding pneumonectomy in centrally located lung cancer.
The purpose of this study was to evaluate surgical outcomes of extended sleeve lobectomy (ESL) in centrally located non-small-cell lung cancer (NSCLC), sparing lung tissue and aggressively avoiding pneumonectomy. ⋯ In patients with centrally located NSCLC, lung-sparing ESL, whose safety and reliability rival that of pneumonectomy, should be considered. Functional effectiveness is higher with right-sided than with left-sided ESL.
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Comparative Study
Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database.
Anastomotic leak is an important cause of morbidity and mortality after esophagectomy. Few studies have targeted risk factors for the development of leak after esophagectomy. The purpose of this study is to use The Society of Thoracic Surgeons Database to identify variables associated with leak after esophagectomy. ⋯ Anastomotic leak after esophagectomy is an important cause of postoperative mortality and increased length of stay. We have identified important risk factors for the development of esophageal anastomotic leak after esophagectomy. Further studies aimed at risk reduction are warranted.