The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Surgical and Long-term Outcomes of Combined Organ Resection for Esophageal Cancer Invading Adjacent Organs: Experience of 90 Consecutive Cases.
To evaluate the feasibility of and long-term survival with combined organ resection for esophageal cancer (EC). ⋯ If patient selection is highly selected, combined organ resection may be a feasible and promising option as a part of the multidisciplinary treatment for EC invading an adjacent organ.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Mixed reality for preoperative planning and intraoperative assistance of surgical correction of complex congenital heart defects.
Mixed reality (MixR) is an innovative visualization tool that presents virtual elements in a real-world environment, enabling real-time interaction between the user and the combined digital/physical reality. We aimed to explore the feasibility of MixR in enhancing preoperative planning and intraoperative guidance for the correction of various complex congenital heart defects. ⋯ MixR represents a promising tool for preoperative planning and 3-dimensional visualization in patients with complex congenital heart defects; however, its systematic adoption in intraoperative settings requires further implementation of current hardware technology and software versatility.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
The Circulatory Arrest Recovery Ammonia Problem (CARAP) Hypothesis: a 1H-MRS study of brain metabolism during neonatal cardiopulmonary bypass surgery.
Congenital heart disease affects 1% of US births, with many babies requiring major cardiothoracic surgery under cardiopulmonary bypass (CPB), exposing the more critical patients to neurodevelopmental impairment. Optimal surgical parameters to minimize neuronal injury are unknown. We used proton magnetic resonance spectroscopy (1H MRS) and blood ammonia assays in a neonatal pig model of CPB to compare 2 approaches, complete circulatory arrest (CA) versus antegrade cerebral perfusion. ⋯ Serial 1H-MRS and blood ammonia assays in this preclinical CPB model identified a previously unreported build-up of ammonia, hypothesized to arise from gut bacterial production, after reperfusion, that may contribute to brain injury in these pediatric surgeries.