The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2013
Comparative StudyNational perioperative outcomes of pulmonary lobectomy for cancer in the obese patient: a propensity score matched analysis.
Obesity in the United States is a growing epidemic that results in challenging patients with complicated comorbidities. We sought to compare hospital outcomes of obese patients with those of nonobese patients undergoing pulmonary lobectomy for cancer. ⋯ Obese patients have an increased risk for postoperative pulmonary complications but not other morbidity, mortality, or prolonged hospital length of stay after lobectomy for cancer. Obesity should not be considered a surgical risk factor for pulmonary resection.
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J. Thorac. Cardiovasc. Surg. · May 2013
Comparative StudyOne thousand minimally invasive mitral valve operations: early outcomes, late outcomes, and echocardiographic follow-up.
The present study assessed the clinical and echocardiographic outcomes for 1000 patients undergoing minimally invasive mitral valve surgery. ⋯ Minimally invasive mitral valve surgery is effective, with excellent late results. The durability of minimally invasive mitral valve repair compared favorably with conventional full sternotomy methods at late follow-up.
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J. Thorac. Cardiovasc. Surg. · May 2013
Comparative StudyRight anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study.
Minimally invasive aortic valve surgery by way of a right anterior minithoracotomy has shown excellent results in terms of mortality, morbidities, and patient satisfaction. The aim of the present study was to compare minimally invasive aortic valve surgery by way of a right anterior minithoracotomy with conventional full sternotomy on early outcomes and midterm survival. ⋯ Right anterior minithoracotomy in patients undergoing isolated aortic valve surgery is associated with a lower incidence of postoperative atrial fibrillation and blood transfusion and shorter ventilation time and hospital length of stay. Prospective randomized trials are needed to confirm our data.
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J. Thorac. Cardiovasc. Surg. · May 2013
Outcome and prognostic factors of pleural mesothelioma after surgical diagnosis and/or pleurodesis.
The objective of this study was to evaluate long-term survival and prognostic factors in patients with malignant pleural mesothelioma. ⋯ Median survival in an unselected population of patients with malignant pleural mesothelioma treated nonsurgically is 12 months. Nonepithelioid histology, older age, abnormal C-reactive protein levels, and leukocytosis are independent predictors of worse survival.
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J. Thorac. Cardiovasc. Surg. · May 2013
Comparative StudyNatural history and clinical effect of aortic valve regurgitation after left ventricular assist device implantation.
Aortic valve regurgitation reduces left ventricular assist device mechanical efficiency. Evidence has also suggested that left ventricular assist device implantation can induce or exacerbate aortic valve regurgitation. However, this has not been compared with aortic valve regurgitation progression in a nonsurgical end-stage heart failure population. Furthermore, its clinical effect is unclear. We sought to characterize the development and progression of aortic valve regurgitation in left ventricular assist device recipients and to identify its clinical effect. ⋯ Native aortic valve regurgitation developed and/or progressed after left ventricular assist device implantation, with this effect being more pronounced in continuous flow left ventricular assist device recipients. However, the preoperative aortic valve regurgitation grade failed to correlate with the development of substantial aortic valve regurgitation after left ventricular assist device implantation. After left ventricular assist device implantation, aortic valve regurgitation had a small, but discernible, clinical effect, with some patients developing severe aortic valve regurgitation and requiring aortic valve procedures. These data have implications for the long-term management of left ventricular assist device recipients, in particular as the durability of implantable continuous flow left ventricular assist device therapy improves.