The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2022
Preservation versus replacement of the aortic root for acute type A aortic dissection.
To determine the impact of aortic root preservation versus aortic root replacement (ARR) after acute type A aortic dissection (ATAAD) repair. ⋯ These findings suggest that aortic root preservation may achieve similar midterm outcomes as ARR after ATAAD repair.
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J. Thorac. Cardiovasc. Surg. · Jul 2022
Randomized Controlled TrialRoutine systematic sampling versus targeted sampling during endobronchial ultrasound: A randomized feasibility trial.
Triple normal lymph nodes, appearing benign on computed tomography, positron emission tomography, and endobronchial ultrasound, have less than a 6% probability of malignancy. We hypothesized that targeted sampling (TS), which omits biopsy of triple normal lymph nodes during endobronchial ultrasound, is not an inferior staging strategy to systematic sampling (SS) of all lymph nodes. ⋯ Progression criteria to a pan-Canadian, noninferiority crossover trial comparing TS with SS have been met, and such a trial is warranted.
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J. Thorac. Cardiovasc. Surg. · Jul 2022
ReviewReoperation to correct unsuccessful vascular ring and vascular decompression surgery.
Although most children do well after operations to relieve vascular compression of the esophagus and airway, many will have persistent/recurrent symptoms. We review our surgical experience using a customized approach to correct various etiologies of failure after vascular ring/decompression surgery. ⋯ Persistent/recurrent symptoms after release of vascular compression are frequently caused by 5 different etiologies. A multidisciplinary strategy for workup and a customized operative approach can effectively treat these cases and may suggest opportunity at the index surgery to prevent reoperation and achieve optimal outcomes.