The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2016
Multicenter StudyAssociation of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study.
Acute kidney injury is common after cardiac surgery and associated with postoperative mortality. Perioperative cardiac biomarkers may predict acute kidney injury and mortality. We evaluated whether cardiac biomarkers were associated with severe acute kidney injury, defined as a doubling in serum creatinine or requiring renal replacement therapy during hospital stay after surgery, and mortality. ⋯ Of the studied biomarkers, N-terminal prohormone of brain natriuretic peptide was the only preoperative biomarker independently associated with severe acute kidney injury and mortality. Early increases in postoperative cardiac biomarkers were associated with severe acute kidney injury after cardiac surgery. Future research should focus on whether interventions that lower N-terminal prohormone of brain natriuretic peptide can affect postoperative outcomes.
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This study analyzed the outcome of a combined endovascular and debranching procedure for hybrid aortic arch repair in patients with chronic dissecting aortic aneurysms involving the aortic arch. ⋯ Hybrid aortic arch repair for dissecting aneurysm is associated with acceptable early and midterm major morbidity and mortality, even for patients treated in zone 0. However, given the high rate of reintervention and endoleak, close follow-up is required.
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J. Thorac. Cardiovasc. Surg. · Jul 2016
Pulmonary metastasectomy for suspected pancreaticobiliary cancer.
Occasionally, pancreaticobiliary cancer presents as a relatively indolent disease and localized blood-borne lung metastases may be resectable. We reviewed our experience with therapeutic lung resections in pancreatic cancer patients. ⋯ Although pancreaticobiliary cancers have an overall dismal prognosis, we recommend pulmonary metastasectomy in highly selected patients. Additionally, not all new lung masses in pancreatic cancer patients are metastases, and resection should be considered, for a second primary lung cancer is often found.
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J. Thorac. Cardiovasc. Surg. · Jul 2016
Metformin exposure is associated with improved progression-free survival in diabetic patients after resection for early-stage non-small cell lung cancer.
There are little clinical data assessing the antineoplastic effect of metformin in patients with non-small cell lung cancer. We hypothesized that in diabetic patients undergoing pulmonary resection for early-stage non-small cell lung cancer, metformin exposure is associated with improved survival. ⋯ Metformin exposure in diabetic patients with early-stage non-small cell lung cancer may be associated with improved progression-free survival, but no effect was seen on overall survival. Further studies are warranted to evaluate if there is a therapeutic role for metformin in the treatment of non-small cell lung cancer.
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J. Thorac. Cardiovasc. Surg. · Jul 2016
Comparative StudyThe rise of new technologies for aortic valve stenosis: A comparison of sutureless and transcatheter aortic valve implantation.
Transcatheter aortic valve implantation (TAVI) and sutureless aortic valve replacement (SU-AVR) are suitable alternatives to conventional surgery. The aim of this study is to compare early outcomes of patients undergoing TAVI and SU-AVR. ⋯ SU-AVR is associated with better device success and a lower incidence of PVL, compared with TAVI. Nevertheless, patients treated with SU-AVR were more likely to receive a permanent pacemaker. SU-AVR and TAVI provide good results in patients who have severe symptomatic aortic valve stenosis. Given the multiple therapeutic options available, patients may receive the treatment that is most appropriate for their clinical and anatomical characteristics.