The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2019
Extent of lymphadenectomy is associated with oncological efficacy of sublobar resection for lung cancer ≤2 cm.
Sublobar resection (SLR) is an alternative to lobectomy for early non-small cell lung cancer. Comparative effectiveness of these 2 approaches might be modified by the extent of lymph node dissection. ⋯ SLR leads to fewer lymph node removed and is associated with inferior survival compared with lobectomy. A more extensive lymphadenectomy may be associated with equivalent survival between matched patients undergoing SLR and lobectomy.
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J. Thorac. Cardiovasc. Surg. · Jun 2019
Open surgery for descending thoracic aorta in an endovascular era.
Thoracic endovascular aortic repair has become the preferred treatment for a variety of descending thoracic aortic pathologies. However, there are unresolved issues such as morphologic appearance of chronic dissection, persistent false lumen perfusion, and adequacy of landing zone. Enthusiasm for improving the technique of open aortic repair and perioperative management is fading. In this study, we would like to demonstrate how we improve our surgical outcomes by establishing a dedicated aortic multidisciplinary team at the Kawasaki Aortic Center. ⋯ Under a dedicated aortic multidisciplinary team, we demonstrated that open descending thoracic aorta replacement can be performed with excellent early outcomes with low reintervention rates, regardless of the nature of the aortic pathologies.
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J. Thorac. Cardiovasc. Surg. · Jun 2019
Short- and long-term outcomes of aortic root repair and replacement in patients undergoing acute type A aortic dissection repair: Twenty-year experience.
The study objective was to evaluate the perioperative and long-term outcomes of aortic root repair and aortic root replacement and provide evidence for root management in acute type A aortic dissection. ⋯ Aortic root repair and aortic root replacement are appropriate surgical options for acute type A aortic dissection repair with favorable short- and long-term outcomes. Aortic root replacement should be performed for patients with acute type A aortic dissection presenting with an intimal tear at the aortic root, root aneurysm 4.5 cm or greater, connective tissue disease, or unrepairable aortic valvulopathy.
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J. Thorac. Cardiovasc. Surg. · Jun 2019
Postoperative atrial fibrillation is associated with higher scores on predictive indices.
To compare the performance of the CHADS VASc, POAF, and HATCH scoring systems to predict new-onset atrial fibrillation after cardiac surgery. ⋯ The POAF, CHA2DS2-VASc, and HATCH scoring systems showed good discrimination and calibration to predict postoperative atrial fibrillation in patients undergoing cardiac surgery. Among them, the CHA2DS2-Vasc score presented the best discriminative ability for postoperative atrial fibrillation and has the advantage of being easy to calculate.