Seminars in thoracic and cardiovascular surgery
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Semin. Thorac. Cardiovasc. Surg. · Jan 2012
ReviewSpecialty matters in the treatment of lung cancer.
The effect of surgeon volume, hospital volume, and surgeon specialty on operative outcomes has been reported in numerous studies. Short-term and long-term outcome comparisons for pulmonary resection for lung cancer have been performed between general surgeons (GS), cardiothoracic surgeons (CTS), and general thoracic surgeons (TS), using large administrative and inpatient databases. ⋯ Some specific processes of care that account for these improved economic, operative, and oncological outcomes have been identified. Others are not yet specifically known and associated with specialization in thoracic surgery.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2012
ReviewRight ventricular failure after cardiac surgery: management strategies.
Right ventricular failure after cardiac surgery is a difficult clinical dilemma. We review the physiology of right ventricular failure in addition to current management strategies to address it.
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Recent results have demonstrated a major reduction in lung cancer mortality through computed tomography screening and no benefit from chest radiograph (CXR) screening. This presents a huge potential for benefit but also poses challenges regarding management of details to minimize harm. Many unresolved questions remain that must be addressed to implement computed tomography screening for lung cancer in a thoughtful and responsible way.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2012
Historical ArticleRigid plate fixation promotes better bone healing after sternotomy.
Sternotomy is the most common surgically created osteotomy in surgery. Rigid fixation of osteotomies are important for stability and bony union. This review shows the superiority of rigid plate fixation in achieving better bone healing after sternotomy. It also highlights use of plate fixation for mini-sternotomies and rib fractures.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2012
Mechanical support for pulmonary veno-occlusive disease: combined atrial septostomy and venovenous extracorporeal membrane oxygenation.
The use of atrial septostomy for refractory pulmonary hypertension and right ventricular failure results in an adequate left ventricular preload and improved cardiac output at the expense of a profound hypoxic shunt. Combined dual-lumen venovenous extracorporeal membrane oxygenation and atrial septostomy provides extracorporeal gas exchange of venous return before the directional right atrial to left atrial shunt, can be deployed percutaneously, and results in an ambulatory patient with stable hemodynamics.