The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Long-term outcomes after valve-sparing anatomical aortic root reconstruction in acute dissection involving the root.
To evaluate long-term results after valve-sparing surgery of acutely dissected aortic root in which a restoration of root anatomy adjusted to the existing aortic annulus diameter, rather than any kind of downsizing, was performed. ⋯ Selective replacement of pathologic sinuses offers an anatomophysiological albeit curative restoration of acutely dissected aortic root resulting in excellent and durable outcomes in selected patients with acute aortic dissection.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
The influence of hormone replacement therapy on lung cancer incidence and mortality.
Data regarding the effects of hormone replacement therapy (HRT) on non-small cell lung cancer (NSCLC) are mixed. We hypothesized HRT would have a protective benefit with reduced NSCLC incidence among women in a large, prospective cohort. ⋯ These data represent among the largest prospective cohorts suggesting HRT use may have a protective effect on the development of NSCLC among women; the physiological basis of this effect merits further study; however, the results may influence discussion surrounding HRT use in women.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Multiday maintenance of extracorporeal lungs using cross-circulation with conscious swine.
Lung remains the least-utilized solid organ for transplantation. Efforts to recover donor lungs with reversible injuries using ex vivo perfusion systems are limited to <24 hours of support. Here, we demonstrate the feasibility of extending normothermic extracorporeal lung support to 4 days using cross-circulation with conscious swine. ⋯ We demonstrate feasibility of normothermic maintenance of extracorporeal lungs for 4 days by cross-circulation with conscious swine. Cross-circulation approaches could support the recovery of damaged lungs and enable organ bioengineering to improve transplant outcomes.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Surgical treatment of tetralogy of Fallot in symptomatic neonates and young infants.
Optimal management of tetralogy of Fallot in symptomatic neonates and young infants remains controversial. ⋯ The surgical strategy for symptomatic tetralogy of Fallot should be individualized according to the initial size of the pulmonary valve annulus.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Multidisciplinary selection of pulmonary nodules for surgical resection: Diagnostic results and long-term outcomes.
Pulmonary nodules found incidentally or by lung cancer screening differ in prevalence, risk profile, and diagnostic intervention. The results of surgical intervention for incidental versus screening lung nodules during multidisciplinary Pulmonary Nodule and Lung Cancer Screening Clinic (PNLCSC) follow-up have not been reported. ⋯ A unique multidisciplinary PNLCSC for incidental and lung cancer screening-detected nodules with individualized risk assessment reliably identifies primary and metastatic tumors while exposing few patients to diagnostic excision for benign disease. Longer-term outcomes, strategies to limit radiation exposure, and cost control need further study.