The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Supraclavicular node metastasis from thoracic esophageal carcinoma: A surgical series from a Japanese multi-institutional nationwide registry of esophageal cancer.
In the present TNM classification, involvement of supraclavicular nodes is defined as distant metastases. However, the therapeutic value of supraclavicular node dissection remains controversial. The purpose of this study was to evaluate the survival benefit of dissection of metastases to the supraclavicular lymph nodes in patients with thoracic esophageal carcinoma by using a large nationwide registry of esophageal cancer maintained by the Japanese Esophageal Society. ⋯ The survival benefit of dissection of metastases to the supraclavicular lymph nodes was indicated in patients with thoracic esophageal carcinoma. Supraclavicular nodes appear to be regional nodes similar to other regional nodes.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Comparative StudyPalliative pulmonary artery banding versus anatomic correction for congenitally corrected transposition of the great arteries with regressed morphologic left ventricle: long-term results from a single center.
We aimed to compare the long-term results between palliative pulmonary artery banding and anatomic correction for congenitally corrected transposition of the great arteries with regressed morphologic left ventricle. ⋯ In patients with congenitally corrected transposition of the great arteries with deconditioned morphologic left ventricle pulmonary artery banding may be considered an ideal procedure because it allows left ventricle training while improving tricuspid regurgitation. Compared with the double-switch procedure after pulmonary artery banding, prolonged palliative pulmonary artery banding provided a lower mortality rate and indicated better cardiac function.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Video-assisted thoracoscopic surgery for patients with pulmonary coccidioidomycosis.
The study objective was to evaluate the use of video-assisted thoracoscopic surgery for removal of pulmonary sequelae of the fungal infection coccidioidomycosis. ⋯ Although rarely necessary for pulmonary coccidioidomycosis, surgical intervention may be indicated. Specific indications include refractory symptomatic disease and complications of the infection, such as cavity rupture. Excisional biopsies also may be required for diagnostic confirmation of indeterminate pulmonary nodules. With video-assisted thoracoscopic surgery, diagnostic and therapeutic intervention can be undertaken with a low risk of complications and shorter length of hospital stay.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Computational modeling of blood flow in the aorta--insights into eccentric dilatation of the ascending aorta after surgery for coarctation.
To assess whether combining a computational modeling technique with data from patient magnetic resonance imaging studies can detect different fluid dynamics and vascular biomechanical properties of the ascending and horizontal aorta in patients with angulated "gothic" arch geometry compared with those with normal "Romanesque" arch geometry after aortic coarctation repair. ⋯ Our results have shown that wall shear stress is eccentric and significantly increased in the ascending and horizontal aorta in patients with a "gothic" aortic arch after repair of coarctation. This suggests that patients with an angulated "gothic" aortic arch might warrant increased surveillance for aortic complications.