The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Experience of a single institution with femoral vein homograft as right ventricle to pulmonary artery conduit in stage 1 Norwood operation.
Femoral vein homograft can be used be used as valved right ventricle to pulmonary artery conduit in the Norwood operation. We describe the results of this approach, including pulmonary artery growth and ventricular function. ⋯ Femoral vein homograft as a right ventricle to pulmonary artery conduit in the Norwood operation is safe and associated with good pulmonary artery growth and preserved ventricular function as assessed by subjective echocardiography. Catheter intervention of the conduit may be necessary.
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Comparative StudyReadmission rates following esophageal cancer resection are similar at regionalized and non-regionalized centers: A population-based cohort study.
Readmission following esophagectomy affects the patient experience, has important economic implications, and can be tied to hospital reimbursement. Ontario has regionalized thoracic centers; regionalized surgery may lower the readmission rate. We investigated whether surgery at regionalized thoracic centers is associated with reduced readmission following esophageal cancer resection. ⋯ Surgery at a designated thoracic surgery center did not reduce the risk of 90-day readmission following esophageal cancer resection, and readmission rates varied significantly even across thoracic centers. Our results suggest that despite universal, regionalized esophageal cancer care, there appears to be a minimum readmission threshold following esophagectomy that may be clinically necessary.
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Use of per oral endoscopic myotomy is increasing for the treatment of achalasia, with potential for rapid recovery and less invasiveness. We report our experience with per oral endoscopic myotomy to better understand how it fits into a modern paradigm of achalasia management. ⋯ Per oral endoscopic myotomy is a safe and effective intervention that provides clear subjective and objective improvement in patients with achalasia. High postprocedure acid reflux raises concern about future sequelae if used in a nonselective fashion.
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Reduction of plasma angiopoietin-like 2 after cardiac surgery is related to tissue inflammation and senescence status of patients.
A strong relationship between high circulating angiopoietin-like 2 (ANGPTL2) levels, a proinflammatory adipokine, and cardiovascular diseases has been reported. Our objective was to determine whether plasma ANGPTL2 and high-sensitivity C-reactive protein (hs-CRP) levels change postoperatively in patients who underwent heart valve surgery and/or coronary artery bypass grafting. We hypothesized that a corrective cardiac surgery would decrease ANGPTL2 levels. ⋯ In younger patients with lower levels of tissue inflammation and arterial senescence load, ANGPTL2, but not hs-CRP levels decreased after cardiac surgery, suggesting that circulating ANGPTL2 reflects tissue inflammation and senescence.
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Tumor cellular proliferation is associated with enhanced immune checkpoint expression in stage I non-small cell lung cancer.
Ki67 is a marker for tumor proliferative activity and is known to have prognostic significance in multiple solid malignancies. We sought to characterize the relationships among Ki67 expression, immune cell infiltration, and immune checkpoint expression in patients with resected non-small cell lung cancer. ⋯ Increased Ki67 expression is associated with biologically aggressive non-small cell lung cancer, enhanced immune checkpoint expression, and reduced intratumoral immune cell infiltration. These findings were strongest in early-stage disease and warrant further investigation in the context of novel therapeutic agents.