The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · May 2015
A self-adaptive triple-branched stent graft for arch repair during open type A dissection surgery.
To make the open placement of the triple-branched stent graft technique suitable for most patients with acute type A aortic dissection to achieve effective individual total arch repair, we developed a self-adaptive triple-branched stent graft and arch open technique. In this study, we report the clinical experience and outcomes of total arch repair using implantation of this self-adaptive triple-branched stent graft with the aid of the arch open technique. ⋯ The simple implantation of a self-adaptive triple-branched stent graft with the aid of the arch open technique can be used safely in most patients with acute type A aortic dissection for effective individual total arch repair.
-
J. Thorac. Cardiovasc. Surg. · May 2015
Comparative StudyFeasibility of smaller arterial cannulas in venoarterial extracorporeal membrane oxygenation.
To facilitate venoarterial extracorporeal membrane oxygenation (ECMO) insertion for cardiogenic shock, we recently adopted a strategy of using a 15F arterial cannula in all patients, rather than 1 designed to maximize flow. We aimed to compare the clinical outcomes of these 2 strategies. ⋯ Compared with the use of larger cannulas, ECMO with a 15F arterial cannula appears to provide comparable clinical support with reduced bleeding complications.
-
The "elephant trunk" (ET) technique traditionally has been performed to treat complex aortic diseases involving the aortic arch and the descending aorta. Despite the fact that, in recent years, the "frozen elephant trunk" (FET) technique has been used increasingly for such pathologies, discussion is still ongoing in the surgical community regarding which of the 2 techniques is better. We compared our results using the classic ET versus the FET technique. ⋯ In selected patients with combined aortic arch and descending aortic aneurysms limited to the proximal descending aorta, the FET approach potentially allows for single-stage therapy, whereas a second-stage operation is inevitable with the classic ET approach. Moreover, owing to the availability of prefabricated, easy-to-use, FET, hybrid prostheses that result in significantly better outcomes in patients who have acute aortic dissection, type A, and if necessary, and provide an ideal "landing zone" for future endovascular completion, the classic ET procedure is "freezing," in the sense that it is being replaced by the FET approach.
-
J. Thorac. Cardiovasc. Surg. · May 2015
Characterization of microRNA transcriptome in tumor, adjacent, and normal tissues of lung squamous cell carcinoma.
MicroRNAs are a class of regulatory molecules involved in a wide variety of biological processes, including growth, development, and apoptosis. Given the widespread roles of microRNAs in biological processes, understanding their different expression profiles in normal, adjacent, and tumor tissues will provide insights into the consequences of aberrant expression. ⋯ This study describes the use of deep sequencing for comprehensive profiling of microRNAs in lung squamous cell carcinoma. The identified microRNA signatures may provide biomarkers for early detection, subclassification, and potential therapeutic targets of lung squamous cell carcinoma. This study also provides some insights into the molecular mechanism underlying the development and progression of lung squamous cell carcinoma, which may prove helpful for early diagnosis and treatment of the disease.