The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Comparative StudyVideo-assisted mediastinoscopic lymphadenectomy is associated with better survival than mediastinoscopy in patients with resected non-small cell lung cancer.
We aimed to analyze the accuracy of video-assisted mediastinoscopic lymphadenectomy (VAMLA) as a tool for preoperative staging and the impact of the technique on survival in patients with non-small cell lung cancer (NSCLC) undergoing pulmonary resection. ⋯ VAMLA was associated with improved survival in NSCLC patients who had resectional surgery.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Comparative StudyComparative study of bronchial artery revascularization in lung transplantation.
Restoring dual blood supply to transplanted lungs by bronchial artery revascularization (BAR) remains controversial. We compared outcomes after lung transplantation performed with and without BAR. ⋯ BAR is safe, with comparable early outcomes. Benefits of BAR include reduced airway ischemia and complications, lower biopsy tissue grades, fewer infections, and delay of BOS. A multicenter study is needed to establish these benefits.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Lymphatic invasion predicts survival in patients with early node-negative non-small cell lung cancer.
The aim of this study was to assess the influence of lymphatic and vascular invasion on overall survival in patients with surgically resected non-small cell lung cancer (NSCLC) without lymph node and distant metastases. ⋯ Lymphatic invasion represents an independent risk factor for node-negative NSCLC. Its implications on therapy decision making should be further evaluated, especially in early stages.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Comparative StudyManagement of dilated ascending aorta during aortic valve replacement: valve replacement alone versus aorta wrapping versus aorta replacement.
The optimal management of dilated ascending aorta during aortic valve replacement (AVR) remains controversial. This study compared the outcomes among 3 different managements (AVR alone, aorta wrapping, and aorta replacement) for the dilated ascending aorta. ⋯ Compared with concomitant aortic wrapping or replacement, AVR alone achieved similar clinical outcomes, showing considerably low risks of adverse aortic events or relevant aortic expansion in dilated ascending aorta. These findings argue against routine aortic replacement at the time of AVR.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Isolated tricuspid valve surgery in patients with previous cardiac surgery.
Few studies have been published in literature on outcomes of isolated tricuspid valve (TV) surgery when performed as a reoperation. Hence, we analyzed our early and midterm results of TV surgery in this unique group of patients. ⋯ Postoperative results of isolated TV surgery as a reoperation are acceptable when performed electively but dismal in patients undergoing nonelective surgery. Thus, redo TV surgery, when indicated, should be performed sooner rather than later. Minimally invasive surgery through a right lateral minithoracotomy is a safe approach for patients with elective surgery.