The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Single running suture technique is associated with low rate of bronchial complications after lung transplantation.
Lung transplantation has evolved to a routinely performed surgical procedure in patients with end-stage pulmonary disease. Bronchial healing problems are rare but represent a potential life-threatening complication. Herein, we aimed to define the incidence, classification, and treatment of bronchial complications after lung transplantation. ⋯ The single running suture technique is associated with a very low rate of true anastomotic complications. Close follow-up and early endoscopic treatment of patients with anastomotic complications result in excellent long-term outcomes.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Predictors of new persistent opioid use after coronary artery bypass grafting.
Deaths from prescription opioid overdose have quadrupled in the past 15 years, and no studies have evaluated appropriate opioid prescribing after cardiac surgery. The aim of this study is to quantify the amount of outpatient opioids prescribed to patients after coronary artery bypass grafting and determine the incidence and risk factors for new persistent opioid use after coronary artery bypass grafting. ⋯ New persistent opioid use after coronary artery bypass grafting is surprisingly common. Prospective studies are needed to determine the opioid requirements of patients after coronary artery bypass grafting to prevent opioid dependence.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Failure of decellularized porcine small intestinal submucosa as a heart valved conduit.
Decellularized extracellular matrix made from porcine small intestinal submucosa, commercially available as CorMatrix (CorMatrix Cardiovascular, Inc, Roswell, Ga) is used off-label to reconstruct heart valves. Recently, surgeons experienced failures and words of caution were raised. The aim of this study was to evaluate decellularized porcine small intestinal submucosa as right-sided heart valved conduit in a xenogeneic animal model. ⋯ Fifty percent of sheep and 20% of lambs died due to valve failure before the planned follow-up period was complete. A well-functioning valve was seen in 35% of animals, albeit with limited signs of tissue remodeling at ≤3 months after implantation. Further analysis is needed to understand the disturbing dichotomous outcome before clinical application can be advised.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Editorial CommentCommentary: The bigger the better, in everything.