The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Evaluation of simulation training in cardiothoracic surgery: the Senior Tour perspective.
The study objective was to introduce senior surgeons, referred to as members of the "Senior Tour," to simulation-based learning and evaluate ongoing simulation efforts in cardiothoracic surgery. ⋯ By providing the necessary tools, such as task trainers and assessment instruments, the Senior Tour may be one means to enhance simulation-based learning in cardiothoracic surgery. The Senior Tour members can provide regular programmatic evaluation and critical analyses to ensure that proposed simulators are of educational value.
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Impact of tumor size on outcomes after anatomic lung resection for stage 1A non-small cell lung cancer based on the current staging system.
Anatomic segmentectomy may achieve results comparable to lobectomy for early-stage non-small cell lung cancer. The 7th edition of the AJCC Cancer Staging Handbook stratified the previous T1 tumor designation into T1a and T1b subsets, which still define stage 1A node-negative non-small cell lung cancer. We are left to hypothesize whether this classification may aid in directing the extent of surgical resection. We retrospectively reviewed our anatomic segmentectomy and lobectomy management of stage 1A non-small cell lung cancer to determine differences in survival and local recurrence rates based on the new stratification. ⋯ Anatomic segmentectomy may achieve equivalent recurrence and survival compared with lobectomy for patients with stage 1A non-small cell lung cancer. Prospective studies will be necessary to delineate the potential merits of anatomic segmentectomy in this setting.
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Decrease in inflammatory response does not prevent placental dysfunction after fetal cardiac bypass in goats.
One of the most significant responses to fetal cardiac bypass is severe placental dysfunction characterized by increased vascular resistance. We tested the hypothesis that fetal cardiac bypass triggers the activation of nuclear factor kappa-B (NF-KB), a major regulator of inflammatory response, and that pharmacologic inhibition of NF-KB activation by pyrrolidine dithiocarbamate alleviates fetal cardiac bypass-induced placental dysfunction. ⋯ Fetal cardiac bypass-induced inflammatory response possibly mediated by NF-KB caused placental dysfunction. Pharmacologic inhibition of NF-KB activation and decrease in the inflammatory response did not alleviate the placental dysfunction.
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Outcome after repair of atrioventricular septal defect with tetralogy of Fallot.
Long-term outcomes of repair of tetralogy of Fallot associated with complete atrioventricular septal defect are seldom reported. We report our survival and reintervention outcomes over a 29-year time period. ⋯ Excellent long-term survival was achieved after repair of tetralogy of Fallot associated with complete atrioventricular septal defect. Palliation and primary repair resulted in comparable outcomes; as such, primary repair is favored. The choice of right ventricular outflow tract reconstruction affects the need for reoperation.