The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2020
Multicenter StudyDoes [18F] fluorodeoxyglucose-positron emission tomography/computed tomography have a role in cervical nodal staging for esophageal squamous cell carcinoma?
Accurate nodal staging is crucial for esophageal cancer. A prospective study was performed to assess the value of [18F] fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for diagnosing cervical lymph node metastasis (LNM) of esophageal squamous cell carcinoma. ⋯ For cervical LNM of esophageal squamous cell carcinoma, FDG-PET/CT scanning exhibited high specificity but low sensitivity, suggesting that it is of limited value for this purpose.
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J. Thorac. Cardiovasc. Surg. · Aug 2020
Surgical explantation of atrial septal closure devices for refractory nickel allergy symptoms.
Systemic allergic reactions to nickel alloys in percutaneous atrial septal defect occlusion devices have a poorly defined natural history. We describe our experience of surgical removal of the offending device in a series of patients with nickel allergy and refractory symptoms. ⋯ Patients with nickel allergy and severe refractory symptoms after atrial septal defect device implantation experience profound resolution of symptoms and improved quality of life after removal. Nickel allergy should be considered before device insertion, and a low threshold should exist for surgical removal for refractory symptoms.
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J. Thorac. Cardiovasc. Surg. · Aug 2020
Observational StudyObjective measure of learning curves for trainees in cardiac surgery via cumulative sum failure analysis.
Objective measures of cardiac surgery trainee progress are limited despite a push for competency-based assessments. We hypothesized that the cumulative sum failure technique could provide a risk-adjusted, quantitative measure of resident learning curves and competence. ⋯ Outcomes for trainee-performed cardiac surgery procedures were excellent, with no association between individual trainees and adverse events. Cumulative sum failure analysis based on postoperative outcomes is a potential tool for objective evaluation of resident proficiency.
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J. Thorac. Cardiovasc. Surg. · Aug 2020
Practice GuidelineAdult cardiac surgery and the COVID-19 pandemic: Aggressive infection mitigation strategies are necessary in the operating room and surgical recovery.
The COVID-19 pandemic necessitates aggressive infection mitigation strategies to reduce the risk to patients and healthcare providers. This document is intended to provide a framework for the adult cardiac surgeon to consider in this rapidly changing environment. Preoperative, intraoperative, and postoperative detailed protective measures are outlined. These are guidance recommendations during a pandemic surge to be used for all patients while local COVID-19 disease burden remains elevated.