The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2021
Defining low-risk lesions in early-stage esophageal adenocarcinoma.
As endoscopic approaches become more widely used to treat early-stage esophageal cancer, reliably identifying patients with less-aggressive tumors is paramount. We sought to identify risk factors for recurrence in patients with completely resected T1 esophageal adenocarcinoma. ⋯ Pathologic T1 tumors have a 5-year cumulative incidence of recurrence of 15%. Nodal involvement and tumor length were independent risk factors for recurrence, whereas tumors <2 cm in length without lymphovascular invasion were associated with a low risk of recurrence.
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J. Thorac. Cardiovasc. Surg. · Oct 2021
Comparative StudySafety of robotic first rib resection for thoracic outlet syndrome.
Robotic first rib resection (R-FRR) is an emerging approach in the field of thoracic outlet syndrome (TOS) that has technical advantages over traditional open approaches, including superior exposure of the first rib and freedom from retracting neurovascular structures. We set out to define the safety of R-FRR and compare it with that of the conventional supraclavicular approach (SC-FRR). ⋯ R-FRR provides outstanding exposure of the first rib and eliminates retraction of the brachial plexus and its consequences.
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J. Thorac. Cardiovasc. Surg. · Oct 2021
Simple 2-dimensional anatomic model to predict the risk of coronary obstruction during transcatheter aortic valve replacement.
In this study, a 2-dimensional (2D) index relying on preprocedural computed tomography (CT) data was developed to evaluate the risk of coronary obstruction during transcatheter aortic valve replacement (TAVR) procedures. ⋯ The 2D geometric model derived in this study shows promise for identifying patients with low-lying coronary ostium and/or small SOVd that may be safely treated with TAVR. DLC2D/d is more predictive of obstruction or poor TAVR candidacy compared with h and SOVd.
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J. Thorac. Cardiovasc. Surg. · Oct 2021
Local versus distant lung donor procurement does not influence short-term clinical outcomes.
The purpose of this study was to recognize clinically meaningful differences in lung transplant outcomes based on local or distant lung procurement. This could identify if the lung allocation policy change would influence patient outcomes. ⋯ Local lung transplants are associated with shorter ischemic times, lower cost, and greater likelihood of daytime surgery. Short- and intermediate-term outcomes are similar for lung transplants from local and distant donors. The new lung allocation policy, with higher proportion of distant lung transplants, is likely to incur greater costs but provide similar outcomes.