Journal of Chest Surgery最新文献_第4页

Percutaneous OxyRVAD in a Patient with Severe Respiratory Failure and Right Heart Failure: A Case Report. 严重呼吸衰竭和右心衰竭患者的经皮 OxyRVAD：病例报告

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-01-16 DOI: 10.5090/jcs.23.132

Ga Young Yoo, June Lee, Seok Beom Hong, Do Yeon Kim

引用次数: 0

Commentary: The Never-Ending Debate on the Type of Aortic Prosthesis in Patients Aged 50-70, as TAVR Peaks in Popularity: Which Prosthesis Should Be Used for Aortic Valve Replacement? 评论：随着 TAVR 的流行达到顶峰，关于 50-70 岁患者主动脉瓣假体类型的争论从未停止：主动脉瓣置换术应使用哪种假体？

Journal of Chest Surgery Pub Date : 2024-05-05 DOI: 10.5090/jcs.24.044

Seung Hyun Lee

引用次数: 0

The "Weekend Effect" in Extracorporeal Cardiopulmonary Resuscitation. 体外心肺复苏的 "周末效应"。

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-02-20 DOI: 10.5090/jcs.23.086

Kinam Shin, Won Chul Cho, Pil Je Kang

{"title":"The \"Weekend Effect\" in Extracorporeal Cardiopulmonary Resuscitation.","authors":"Kinam Shin, Won Chul Cho, Pil Je Kang","doi":"10.5090/jcs.23.086","DOIUrl":"10.5090/jcs.23.086","url":null,"abstract":"Background: The phenomenon known as the \"weekend effect\" impacts various medical disciplines. We compared outcomes between regular hours and off hours to investigate the presence of the weekend effect in extracorporeal cardiopulmonary resuscitation (ECPR).Methods: Between January 2018 and December 2020, 159 patients at our center were treated with veno-arterial extracorporeal membrane oxygenation (ECMO) for cardiac arrest. We assessed the time required for ECMO preparation, the rate of successful weaning, and the rate of in-hospital mortality. These factors were compared among regular hours (\"daytime\": weekdays from 7:00 AM-7:00 PM), off hours on weekdays (\"nighttime\": weekdays from 7:00 PM-7:00 AM), and off hours on weekends and holidays (\"weekend\": Fridays at 7:00 PM to Mondays at 7:00 AM).Results: The time from the recognition of cardiac arrest to the arrival of the ECMO team was shortest for the daytime group and longest for those treated over the weekend (daytime, 10.0 minutes; nighttime, 12.5 minutes; weekend, 15.0 minutes; p=0.064). The time from the ECMO team's arrival to ECMO initiation was shortest for the daytime and longest for the nighttime group (daytime, 13.0 minutes; nighttime, 18.5 minutes; weekend, 14.0 minutes; p=0.028). No significant difference was observed in the rate of successful ECMO weaning (daytime, 48.3%; nighttime, 39.5%; weekend, 36.1%; p=0.375).Conclusion: In situations involving CPR, the time to arrival of the ECMO team was longer during off hours. Furthermore, ECMO insertion required more time at night than during the other periods. These findings warrant specific training in decision-making and emergent ECMO insertion.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Serratus Anterior Plane Block: A Better Modality of Pain Control after Pectus Excavatum Repair. 冈前平面阻滞：胸肌修复术后更好的疼痛控制方式

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-03-13 DOI: 10.5090/jcs.23.139

Eun Seok Ka, Gong Min Rim, Seungyoun Kang, Saemi Bae, Il-Tae Jang, Hyung Joo Park

{"title":"Serratus Anterior Plane Block: A Better Modality of Pain Control after Pectus Excavatum Repair.","authors":"Eun Seok Ka, Gong Min Rim, Seungyoun Kang, Saemi Bae, Il-Tae Jang, Hyung Joo Park","doi":"10.5090/jcs.23.139","DOIUrl":"10.5090/jcs.23.139","url":null,"abstract":"Background: Postoperative pain management following minimally invasive repair of pectus excavatum (MIRPE) remains a critical concern due to severe post-procedural pain. Promising results have been reported for cryoanalgesia following MIRPE; however, its invasiveness, single-lung ventilation, and additional instrumentation requirements remain obstacles. Serratus anterior plane block (SAPB) is a regional block technique capable of covering the anterior chest wall at the T2-9 levels, which are affected by MIRPE. We hypothesized that SAPB would be a superior alternative pain control modality that reduces postoperative pain more effectively than conventional methods.Methods: We conducted a retrospective study of patients who underwent MIRPE between March 2022 and August 2023. The efficacy of pain control was compared between group N (conventional pain management, n=24) and group S (SAPB, n=26). Group N received intravenous patient-controlled analgesia (IV-PCA) and subcutaneous local anesthetic infusion. Group S received bilateral continuous SAPB with 0.3% ropivacaine after a bilateral bolus injection of 30 mL of 0.25% ropivacaine with baseline IV-PCA. Pain levels were evaluated using a Visual Analog Scale (VAS) at 1, 3, 6, 12, 24, 48, and 72 hours postoperatively and total intravenous rescue analgesic consumption by morphine milligram equivalents (MME).Results: Mean VAS scores were significantly lower in group S than in group N throughout the 72-hour postoperative period (p<0.01). Group S showed significantly lower MME at postoperative 72 hours (group N: 108.53, group S: 16.61; p<0.01).Conclusion: SAPB improved immediate postoperative pain control in both the resting and dynamic states and reduced opioid consumption compared to conventional management.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Midterm Results of Surgical Aortic Valve Replacement with Sutureless Valves. 使用无缝线瓣膜进行主动脉瓣置换术的临床中期结果。

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-03-26 DOI: 10.5090/jcs.23.142

Soonchang Hong, Jung-Woo Son, Yungjin Yoon

{"title":"Clinical Midterm Results of Surgical Aortic Valve Replacement with Sutureless Valves.","authors":"Soonchang Hong, Jung-Woo Son, Yungjin Yoon","doi":"10.5090/jcs.23.142","DOIUrl":"10.5090/jcs.23.142","url":null,"abstract":"Background: Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis.Methods: Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020. In total, 113 patients were included (mean age, 75.3±8.4 years; 57.5% women; median Society of Thoracic Surgeons score, 9.7%; mean follow-up period, 51.19±20.6 months). Of these patients, 41 were octogenarians (36.2%) and 3 were nonagenarians (2.6%). Transthoracic echocardiography was employed to assess changes in ejection fraction (EF), left ventricular mass index (LVMI), and mean pressure gradient (MPG).Results: The in-hospital mortality rate was 2.6%, and 13 patients developed new-onset atrial fibrillation. A permanent pacemaker was implanted in 3 patients (2.6%). The median intensive care unit stay was 1 day (interquartile range [IQR], 1-2 days), and the median hospital stay was 12 days (IQR, 9.5-15 days). The overall survival rate at 5 years was 95.9%. LVMI and MPG were reduced postoperatively, while EF increased over the follow-up period. No structural valve deterioration was observed, and no meaningful paravalvular leakage developed during follow-up.Conclusion: The use of a sutureless valve in the aortic position is safe and feasible, even for high-risk elderly patients requiring surgical AVR. LVMI and MPG decreased postoperatively, while EF increased over the follow-up period.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unexpected Restart Failure of Durable Left Ventricular Assist Devices: A Report of Two Cases. 耐用左心室辅助装置意外重启失败：两个病例的报告。

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-01-16 DOI: 10.5090/jcs.23.104

Hyo Won Seo, Ga Hee Jeong, Sung Min Kim, Minjung Bak, Darae Kim, Jin-Oh Choi, Kiick Sung, Yang Hyun Cho

引用次数: 0

Immunological Analysis of Postoperative Delirium after Thoracic Aortic Surgery. 胸主动脉手术后谵妄的免疫学分析

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-03-13 DOI: 10.5090/jcs.23.159

Haein Ko, Mukhammad Kayumov, Kyo Seon Lee, Sang Gi Oh, Kook Joo Na, In Seok Jeong

{"title":"Immunological Analysis of Postoperative Delirium after Thoracic Aortic Surgery.","authors":"Haein Ko, Mukhammad Kayumov, Kyo Seon Lee, Sang Gi Oh, Kook Joo Na, In Seok Jeong","doi":"10.5090/jcs.23.159","DOIUrl":"10.5090/jcs.23.159","url":null,"abstract":"Background: Delirium is a recognized neurological complication following cardiac surgery and is associated with adverse clinical outcomes, including elevated mortality and prolonged hospitalization. While several clinical risk factors for post-cardiac surgery delirium have been identified, the pathophysiology related to the immune response remains unexamined. This study was conducted to investigate the immunological factors contributing to delirium in patients after thoracic aortic surgery.Methods: We retrospectively evaluated 43 consecutive patients who underwent thoracic aortic surgery between July 2017 and June 2018. These patients were categorized into 2 groups: those with delirium and those without it. All clinical characteristics were compared between groups. Blood samples were collected and tested on the day of admission, as well as on postoperative days 1, 3, 7, and 30. Levels of helper T cells (CD4), cytotoxic T cells (CD8), B cells (CD19), natural killer cells (CD56+CD16++), and monocytes (CD14+CD16-) were measured using flow cytometry.Results: The median patient age was 71 years (interquartile range, 56.7 to 79.0 years), and 21 of the patients (48.8%) were male. Preoperatively, most immune cell counts did not differ significantly between groups. However, the patients with delirium exhibited significantly higher levels of interleukin-6 and lower levels of tumor necrosis factor-alpha (TNF-α) than those without delirium (p<0.05). Multivariate analysis revealed that lower TNF-α levels were associated with an increased risk of postoperative delirium (p<0.05).Conclusion: Postoperative delirium may be linked to perioperative changes in immune cells and preoperative cytokine levels. Additional research is required to elucidate the pathophysiological mechanisms underlying delirium.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful Bridge to Heart Transplantation through Ventricular Assist Device Implantation and Concomitant Fontan Completion in a Patient with Glenn Physiology: A Case Report. 格伦生理学患者通过心室辅助装置植入并伴随Fontan完成心脏移植的成功桥梁:一例报告。

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2023-12-07 DOI: 10.5090/jcs.23.108

Ji Hong Kim, Ji Hoon Kim, Ah Young Kim, Yu Rim Shin

{"title":"Successful Bridge to Heart Transplantation through Ventricular Assist Device Implantation and Concomitant Fontan Completion in a Patient with Glenn Physiology: A Case Report.","authors":"Ji Hong Kim, Ji Hoon Kim, Ah Young Kim, Yu Rim Shin","doi":"10.5090/jcs.23.108","DOIUrl":"10.5090/jcs.23.108","url":null,"abstract":"A 3-year-old boy with Glenn physiology exhibited refractory heart failure with reduced ejection fraction. To improve the patient's oxygen saturation, he underwent ventricular assist device (VAD) implantation with concomitant Fontan completion. The extracardiac conduit Fontan operation was performed with a 4-mm fenestration. For VAD implantation, Berlin Heart cannulas were positioned at the left ventricular apex and the neo-aorta. Following weaning from cardiopulmonary bypass, a temporary continuous-flow VAD, equipped with an oxygenator, was utilized for support. After a stabilization period of 1 week, the continuous-flow VAD was replaced with a durable pulsatile-flow device. Following 3 months of support, the patient underwent transplantation without complications. The completion of the Fontan procedure at the time of VAD implantation, along with the use of a temporary continuous-flow device with an oxygenator, may aid in stabilizing postoperative hemodynamics. This approach could contribute to a safe transition to a durable pulsatile VAD in patients with Glenn physiology.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Commentary: A Complex Issue with a Straightforward Answer. 评论：复杂的问题，简单的答案。

Journal of Chest Surgery Pub Date : 2024-05-05 DOI: 10.5090/jcs.24.045

Dong-Hee Kim

引用次数: 0

Development of a Risk Scoring Model to Predict Unexpected Conversion to Thoracotomy during Video-Assisted Thoracoscopic Surgery for Lung Cancer. 开发风险评分模型，预测视频辅助胸腔镜肺癌手术中意外转为胸廓切开术的风险。

Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-03-13 DOI: 10.5090/jcs.23.140

Ga Young Yoo, Seung Keun Yoon, Mi Hyoung Moon, Seok Whan Moon, Wonjung Hwang, Kyung Soo Kim

{"title":"Development of a Risk Scoring Model to Predict Unexpected Conversion to Thoracotomy during Video-Assisted Thoracoscopic Surgery for Lung Cancer.","authors":"Ga Young Yoo, Seung Keun Yoon, Mi Hyoung Moon, Seok Whan Moon, Wonjung Hwang, Kyung Soo Kim","doi":"10.5090/jcs.23.140","DOIUrl":"10.5090/jcs.23.140","url":null,"abstract":"Background: Unexpected conversion to thoracotomy during planned video-assisted thoracoscopic surgery (VATS) can lead to poor outcomes and comparatively high morbidity. This study was conducted to assess preoperative risk factors associated with unexpected thoracotomy conversion and to develop a risk scoring model for preoperative use, aimed at identifying patients with an elevated risk of conversion.Methods: A retrospective analysis was conducted of 1,506 patients who underwent surgical resection for non-small cell lung cancer. To evaluate the risk factors, univariate analysis and logistic regression were performed. A risk scoring model was established to predict unexpected thoracotomy conversion during VATS of the lung, based on preoperative factors. To validate the model, an additional cohort of 878 patients was analyzed.Results: Among the potentially significant clinical variables, male sex, previous ipsilateral lung surgery, preoperative detection of calcified lymph nodes, and clinical T stage were identified as independent risk factors for unplanned conversion to thoracotomy. A 6-point risk scoring model was developed to predict conversion based on the assessed risk, with patients categorized into 4 groups. The results indicated an area under the receiver operating characteristic curve of 0.747, with a sensitivity of 80.5%, specificity of 56.4%, positive predictive value of 1.8%, and negative predictive value of 91.0%. When applied to the validation cohort, the model exhibited good predictive accuracy.Conclusion: We successfully developed and validated a risk scoring model for preoperative use that can predict the likelihood of unplanned conversion to thoracotomy during VATS of the lung.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0