Showing papers in "The Journal of Thoracic and Cardiovascular Surgery in 1995"

TL;DR: Three facts emerge as significant: (1) Systematic lymph node dissection is necessary to ensure that the disease is accurately staged; (2) lesser resections (wedge/segment) result in high recurrence rates and reduced survival regardless of histologic type; and (3) second primary lung cancers are prevalent in long-term survivors.

TL;DR: Surgical bilateral lung volume reduction may be of significant value for selected patients with severe chronic obstructive pulmonary disease and marked relief of dyspnea and improvement in exercise tolerance and quality of life.

TL;DR: The maze III procedure is now the technique of choice for the management of medically refractory atrial fibrillation and is associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improvedLong-term atrial transport function.

TL;DR: The operative technique of the maze III procedure for the treatment of patients with medically refractory atrial flutter and atrial fibrillation is described in a sequential fashion.

TL;DR: A total of 503 patients underwent 521 tracheal resections and reconstructions for postintubation stenosis from 1965 through 1992, with good or satisfactory results, and the most common complication, suture line granulations, has almost vanished with the use of absorbable sutures.

TL;DR: Recipients with obliterative bronchiolitis detected in the preclinical stage were significantly more likely to be in remission than recipients who had clinical disease at the time of diagnosis and results indicate that acute rejection is the most significant risk factor for development of obliteration and that obliteration responds to treatment with augmented immunosuppression when it is detected early by surveillance transbronchial biopsy.

TL;DR: Higher mean arterial pressures during cardiopulmonary bypass can be achieved in a technically safe manner and effectively improve outcomes after coronary bypass.

TL;DR: For patients with cardiomyopathy and severe mitral regurgitation, mitral valve reconstruction as opposed to replacement can be accomplished with low operative and early mortality, yielding improvement in symptomatic status and survival.

TL;DR: In this article, a randomized study was carried out to define the advantages of video-assisted thoracic surgery over muscle-sparing thoracotomy and lobectomy, and the authors concluded that video assisted lobectomy was not associated with a significant decrease in duration of chest tube drainage, length of hospital stay, postthoracotomy pain, or, in this group of patients, a faster recovery time and return to work.

TL;DR: It is concluded that axillary artery cannulation is a safe and effective means of providing antegrade arterial flow during cardiopulmonary bypass in patients with severe atherosclerotic or aneurysmal disease and may lower the prevalence of stroke associated with cardiopulo pulmonary bypass in these patients.

TL;DR: In this paper, the authors used transcranial Doppler ultrasonography to detect and quantify the number of microemboli in the right middle cerebral artery of patients undergoing elective first coronary bypass operations (n = 117) and second coronary bypass operation ( n = 10).

TL;DR: Pulsatility has no effect on central nervous system outcomes, but alpha-stat management is associated with a decreased incidence of cognitive dysfunction in patients undergoing prolonged cardiopulmonary bypass.

TL;DR: The data suggest that cardiac operations can be done safely 4 weeks after cerebral infarction, and if the delay is more than 2 weeks, the exacerbation rate will be around 10%, and the risk of progression of cerebral damage is still significant 15 days and even 4 weeks afterwards.

TL;DR: The analyses indicate that both the mortality and reintervention risks are lower in patients with less complex anatomy and the need for reinterventions has decreased with time.

TL;DR: In this paper, the authors evaluated the impact of heparin and protamine administration on the incidence and treatment of bleeding after cardiopulmonary bypass and found that higher protamine dose was associated with higher postoperative bleeding.

TL;DR: Reimplantation and remodeling of the aortic root reconstruction have provided excellent clinical results in carefully selected adult patients.

TL;DR: Low-dose aprotinin has a similar antiinflammatory effect to that of methylprednisolone in blunting cardiopulmonary bypass-induced systemic tumor necrosis factor-alpha release and neutrophil integrin CD11b upregulation.

TL;DR: It is concluded that homovital valves demonstrate good durability, particularly in patients older than 30 years, who had a 10-year freedom from degeneration rate of 97%.

TL;DR: Repairs of acute postinfarction ventricular septal defect by endocardial patch with infarct exclusion of the left ventricule probably avoids additional damage to the right ventricle, remodels the acutely infarCTed left ventricularle, and enhances survival.

TL;DR: During a 25-year period 69 patients whose ages ranged from 1 day to 64 years were treated for bronchogenic cyst of the mediastinum, there was one hospital death caused by a centrally located compressive cyst that was undiagnosed at thoracotomy.

TL;DR: It is concluded that successful outcome of lung transplantation can be achieved with the use of marginal donor lungs, and cardiopulmonary bypass was required to facilitate second graft insertion in bilateral sequential transplants more often in the marginal group than in group I.

TL;DR: It is indicated that both aortic and pulmonary homografts provided excellent intermediate-term patient survival after right ventricular outflow tract reconstruction, but pulmonary homogsrafts are more durable than aortics with less calcification and obstruction, especially among children 4 years old or younger.

TL;DR: The treatment of flail chest injury in this series by internal fixation resulted in speedy recovery, decreased complications, and better ultimate cosmetic and functional results and proved to be cost effective.

TL;DR: The data suggest that video-assisted thoracic surgery is a viable alternative to thoracotomy for the treatment of recurrent spontaneous pneumothorax and results in a short hospital stay, low morbidity, high patient acceptance, and a low rate of recurrence.

TL;DR: This approach establishes normal cardiovascular physiology early in life, eliminates the need for multiple systemic-pulmonary artery shunts and use of prosthetic material, and minimizes the number of operations required.

TL;DR: If performed in all patients before open biopsy, PET increases the diagnostic yield by reducing the number of patients who have benign lesions at operation and by lowering expenditures for hospitalization and other diagnostic procedures, FDG PET may significantly reduce health care costs.

TL;DR: A pathologic examination can identify the patients with a poor prognosis, which is different among the stages, and a multivariate prognostic factor analysis showed that the grade of differentiation, pleural involvement, and venous invasion in stage I; the histologic cell type and Pleural involvement in stage II; and ven Mous invasion and mediastinal lymph node metastasis in stageIIIA were all predominant prognostic factors.

TL;DR: There is little interrelationship of predicted postoperative diffusing capacity percent and predicted postoperatively forced expiratory volume in 1 second, indicating that these values should be assessed independently in estimating operative risk.

TL;DR: From October 1989 to February 1992, 74 patients with mediastinoscopically staged IIIA (N2) non-small-cell lung cancer from 30 CALGB-affiliated hospitals received two cycles of preresectional cisplatin and vinblastine chemotherapy.

TL;DR: In this article, a double-blind, randomized study comparing outcomes after alpha-stat or pH-stat management and pulsatile or nonpulsatile perfusion during moderate hypothermic cardiopulmonary bypass was undertaken in 316 patients undergoing coronary artery bypass operations.