The Annals of thoracic surgery
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Despite recent studies reporting on the results of prospective intentional sublobar resection for patients with small non-small cell lung cancer (NSCLC), few studies have investigated predictors for prognosis or recurrence exclusively in patients undergoing intentional sublobar resection. ⋯ The factors related to upstaging on pathologic diagnosis were not identified as independent predictors; therefore, the current patient selection criterion seems reasonable. If lymphatic permeation is present on pathologic findings, careful follow-up is recommended. The predictors identified in this study will support assessment and interpretation of the results of ongoing prospective randomized trials of lobar versus sublobar resection in patients with small peripheral NSCLC.
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Comparative Study
Midterm benefits of preoperative statin therapy in patients undergoing isolated valve surgery.
Recent data have suggested that statins are associated with reduced early mortality and cardiovascular events after valvular heart surgery. The midterm effects of preoperative statin therapy in the setting of valvular heart surgery are presently unclear. ⋯ Preoperative statin administration is associated with early reductions in mortality among patients undergoing isolated valvular heart surgery, leading to improved late survival. Future prospective analyses are warranted to optimize statin therapy in this patient population.
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This investigation evaluated whether the performance at a preoperative symptom-limited stair-climbing test was a prognostic factor in resected pathologic stage I non-small cell lung cancer (NSCLC). ⋯ Preoperative cardiopulmonary fitness is a significant prognostic factor in patients after resection for early-stage NSCLC. Interventions aimed at improving exercise tolerance can be useful to improve long-term prognosis after NSCLC operations.
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Comparative Study
Preoperative recipient cytokine levels are associated with early lung allograft dysfunction.
Primary graft dysfunction (PGD) is a morbid complication after lung transplant (LTx). Recipient before and after cytokine and chemokine profiles may be associated with a recipient's propensity to have PGD. ⋯ Higher before and after transplant cytokine/chemokine levels were found in LTx recipients who subsequently had PGD grade 2 or more. Our study demonstrates that the recipient's inflammatory state at the time of LTx may impact early allograft function. That could represent a potential target for pretransplant pharmacologic intervention.
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The Yasui procedure is employed in neonates with interrupted aortic arch and left ventricular outflow tract obstruction (IAA/LVOTO) or aortic atresia-severe stenosis with ventricular septal defect (AA/VSD) and 2 adequate-sized ventricles. This combines a Norwood arch reconstruction with a Rastelli operation establishing a biventricular repair. ⋯ The Yasui operation is effective for patients with IAA/LVOTO and AA/VSD. Primary and staged repair have comparable results. Reoperation after biventricular repair seems inevitable, mostly for conduit replacement. Genetic factors may affect long-term survival.