The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2018
WebcastsFactors associated with distant recurrence following R0 lobectomy for pN0 lung adenocarcinoma.
We investigated factors associated with distant recurrence, disease-free survival (DFS), and overall survival (OS) following R0 lobectomy for pathologic node-negative (pN0) lung adenocarcinoma. ⋯ In patients undergoing R0 lobectomy with pN0 lung adenocarcinoma, pT stage and lymphovascular invasion were associated with distant recurrence and decreased DFS. These observations support the inclusion of these patients in future clinical trials investigating adjuvant targeted and immunotherapies.
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J. Thorac. Cardiovasc. Surg. · Mar 2018
Isolated and concomitant minimally invasive minithoracotomy aortic valve surgery.
To evaluate whether the outcomes of minimally invasive aortic valve surgery were similar in younger versus older patient groups, as well as whether concomitant minimally invasive aortic valve replacement (AVR) surgeries added significant risks in these populations. ⋯ Minimally invasive right thoracotomy AVR surgery was associated with low stroke and mortality rates in all age groups within 30 days of surgery. Similarly, minithoracotomy concomitant AVR surgery demonstrated excellent results and is deemed feasible in patients with multiple pathologies.
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J. Thorac. Cardiovasc. Surg. · Mar 2018
Comparative StudyPrognostic significance and adjuvant chemotherapy survival benefits of a solid or micropapillary pattern in patients with resected stage IB lung adenocarcinoma.
To evaluate the prognostic significance and beneficiaries of adjuvant chemotherapy (ACT) in various histological patterns of stage IB lung adenocarcinoma according to the 8th tumor-node-metastasis (TNM) classification. ⋯ Solid/micropapillary patterns were associated with poor prognosis, even if they were not predominant. ACT contributed to survival benefits in the SMPP subgroup of patients with stage IB lung adenocarcinoma.
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J. Thorac. Cardiovasc. Surg. · Mar 2018
Selective implantation of durable left ventricular assist devices as primary therapy for refractory cardiogenic shock.
Surgical therapy for refractory primary cardiogenic shock is largely based on emergent placement of extracorporeal membrane oxygenation or short-term ventricular assist devices. We have adopted a strategy of routine implantation of durable left ventricular assist devices (LVAD) as initial therapy for refractory cardiogenic shock, in patients who are potential candidates for heart transplantation, and report our experience. ⋯ Our data challenge the notion that patients in refractory cardiogenic shock are best served by an initial period of stabilization with temporary devices. Primary implantation of durable LVADs in cardiogenic shock can yield good midterm outcomes and may have potential benefits.