The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2018
Patients experiencing early acute respiratory failure have high postoperative mortality after pneumonectomy.
Post-pneumonectomy acute respiratory failure leading to invasive mechanical ventilation carries a severe prognosis especially when acute respiratory distress syndrome occurs. The aim of this study was to describe risk factors and outcome of acute respiratory failure. ⋯ Early acute respiratory failure requiring reintubation remains a severe complication of pneumonectomy with a poor outcome.
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J. Thorac. Cardiovasc. Surg. · Dec 2018
Multicenter Study Comparative Study Pragmatic Clinical TrialMini-Stern Trial: A randomized trial comparing mini-sternotomy to full median sternotomy for aortic valve replacement.
Aortic valve replacement (AVR) can be performed either through full median sternotomy (FS) or upper mini-sternotomy (MS). The Mini-Stern trial aimed to establish whether MS leads to quicker postoperative recovery and shorter hospital stay after first-time isolated AVR. ⋯ Compared with FS for AVR, MS did not result in shorter hospital stay, faster recovery, or improved survival and was not cost-effective. The MS approach is not superior to FS for performing AVR.
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J. Thorac. Cardiovasc. Surg. · Dec 2018
Outcomes of venopulmonary arterial extracorporeal life support as temporary right ventricular support after left ventricular assist implantation.
We report our experience with temporary postoperative venopulmonary arterial extracorporeal life support as short-term right ventricular support in patients with biventricular failure undergoing HeartWare (HeartWare Inc, Framingham, Mass) left ventricular assist device implantation and compared these outcomes with isolated left ventricular assist device support and long-term biventricular assist device support. ⋯ In critically unwell patients requiring temporary biventricular support, planned venopulmonary arterial extracorporeal life support provides acceptable outcomes, similar to durable biventricular assist device support. Requirement for venopulmonary arterial extracorporeal life support is more determined by the level of preoperative acuity than echocardiographic or hemodynamic parameters.