Annals of thoracic surgery short reports最新文献

{"title":"Cardiac Resynchronization Therapy for Pacing-Related Dysfunction Post Cardiac Surgery in Neonates","authors":"Jesus C. Jaile IV MD ,&nbsp;Jacquelyn D. Brady PA ,&nbsp;Patrick Nelson PA ,&nbsp;Wesam Sourour MD ,&nbsp;Melvin C. Almodovar MD ,&nbsp;Scott Macicek MD ,&nbsp;Timothy W. Pettitt MD ,&nbsp;Frank A. Pigula MD","doi":"10.1016/j.atssr.2024.05.007","DOIUrl":"10.1016/j.atssr.2024.05.007","url":null,"abstract":"<div><div>An infant with DiGeorge syndrome, multiple comorbidities, and truncus arteriosus type II underwent repair complicated by heart block necessitating placement of a dual-chamber bipolar pacing system with right ventricular leads and subsequent resynchronization with placement of left ventricular apical pacing leads. Resynchronization therapy improved QRS duration from 180 ms to 100 ms and ejection fraction from 25% to 54% over the course of 4 weeks with gradual return to normal function and eventual discharge.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 825-828"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397589","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}

{"title":"Remote Perioperative Monitoring in Adult Cardiac Surgery: The Impact on 1000 Consecutive Patients","authors":"Kevin W. Lobdell MD ,&nbsp;Shannon Crotwell BS, CCRN ,&nbsp;Larry T. Watts MD ,&nbsp;Bradley LeNoir MD ,&nbsp;Eric R. Skipper MD ,&nbsp;Thomas Maxey MD ,&nbsp;Gregory B. Russell MS ,&nbsp;Robert Habib PhD ,&nbsp;Geoffrey A. Rose MD ,&nbsp;John Frederick MD","doi":"10.1016/j.atssr.2024.06.018","DOIUrl":"10.1016/j.atssr.2024.06.018","url":null,"abstract":"<div><h3>Background</h3><div>Our remote patient monitoring (RPM) program for adult cardiac surgery patients aims to remove barriers to access, provide continuity of expert care, and increase their time-at-home. The RPM program integrates novel biosensors, an application for audiovisual visits, messaging, biometric data tracking, patient-reported outcomes, and scheduling with the aim of reducing postoperative length of stay and 30-day readmissions, while simultaneously increasing the rate of patients discharged to home.</div></div><div><h3>Methods</h3><div>Our institutional database was utilized for this retrospective review of 1000 consecutive RPM patients who underwent coronary artery bypass, valve, and coronary artery bypass + valve, at 3 hospitals from July 2019 through April 2023. The study cohort was compared with 1000 propensity-matched controls from the same three hospitals (1:1, nearest neighbor matching where propensity scores were generated with RPM as the outcome measure). Patient characteristics, procedures, and outcomes are defined as per The Society of Thoracic Surgeons Adult Cardiac Database.</div></div><div><h3>Results</h3><div>RPM patients experienced statistically significant shorter median postoperative length of stay (1 day less, a 16.7% relative difference; <em>P</em> &lt; .0001) and a 33% relative reduction in 30-day readmission (7.0 ± 0.8 vs 4.7 ± 0.7, <em>P</em> = .027), while 5.6% more patients were discharged to home (97.8% vs 92.2%, <em>P</em> &lt; .0001) when compared with the non-RPM cohort.</div></div><div><h3>Conclusions</h3><div>Patient engagement and management with a RPM platform are feasible and associated with significantly shorter postoperative length of stay, fewer 30-day readmissions, and an increased rate of discharge to home.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 860-864"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704729","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}

{"title":"The Role of Endobronchial Ultrasound for Mediastinal Staging in Mesothelioma","authors":"Desiree Steimer MD ,&nbsp;Peter Tramontozzi BS ,&nbsp;Patrick Gedeon MD, PhD ,&nbsp;Matthew Pommerening MD, MS ,&nbsp;Ariadne DeSimone MD, MPH ,&nbsp;Raphael Bueno MD ,&nbsp;Hisashi Tsukada MD, PhD","doi":"10.1016/j.atssr.2024.06.024","DOIUrl":"10.1016/j.atssr.2024.06.024","url":null,"abstract":"<div><h3>Background</h3><div>Invasive mediastinal staging is a crucial component of the preoperative evaluation for potential surgical candidates with pleural mesothelioma (PM). Endobronchial ultrasound (EBUS) is less invasive than mediastinoscopy for staging; however, its accuracy in patients with PM remains undefined. We present our institutional experience with EBUS staging in patients with PM.</div></div><div><h3>Methods</h3><div>Patients with PM who underwent EBUS for mediastinal staging between January 2017 and February 2021 (Brigham and Women's Hospital, Boston, MA) followed by surgical resection were retrospectively reviewed. EBUS cytology was compared with final pathology reports for the corresponding lymph node removed at the time of pleurectomy to assess EBUS accuracy.</div></div><div><h3>Results</h3><div>During the study period, 91 patients with PM met inclusion criteria. EBUS diagnostic yield was highest at nodal station 7 (84%) and lowest at station 4L (40%). There were 74 patients taken for surgical resection, and 41 patients had matching lymph nodes for analysis. In our series, EBUS had a sensitivity of 81%, a specificity of 93%, a positive predictive value of 90%, and a negative predictive value of 84%.</div></div><div><h3>Conclusions</h3><div>EBUS is a reasonable alternative to mediastinoscopy for mediastinal staging in patients with mesothelioma.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 613-617"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712121","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}

{"title":"Arch Bare Metal Stent Grafting in Type I Aortic Dissections After Hemiarch Repair","authors":"Kendal M. Endicott MD ,&nbsp;Hannah Pambianchi BA ,&nbsp;David Spinosa MD ,&nbsp;Liam Ryan MD","doi":"10.1016/j.atssr.2024.06.025","DOIUrl":"10.1016/j.atssr.2024.06.025","url":null,"abstract":"<div><h3>Background</h3><div>DeBakey type I aortic dissections (AD) are most frequently treated with hemiarch repair. A subset of patients demonstrates persistent distal end-organ ischemia secondary to persistent true lumen (TL) compression. We describe the use of bare metal stent grafting across the residual arch dissection with the Zenith Dissection Endovascular Stent (ZDES, Cook Medical) in 7 patients with type I AD that was repaired in a hemiarch configuration with a compromised distal TL and organ malperfusion.</div></div><div><h3>Methods</h3><div>Seven patients underwent ZDES placement from a hemiarch repair across the arch with extension to the aortic bifurcation in the acute and subacute phases. Pressure gradients between the ascending aorta and the femoral access were recorded. Preprocedure and postprocedure computed tomographic images were analyzed using centerline reconstruction. TL and false lumen areas were calculated on the basis of manually performed measurements on 8 points along the aorta.</div></div><div><h3>Results</h3><div>All 7 cases were technically successful, without evidence of perioperative stroke or intraoperative death. There was a statistically significant increase in median TL area at all locations except 1 cm above the aortic bifurcation (<em>P</em> &lt;.05). Pressure gradients between the ascending aorta and the femoral access in measured cases improved after stenting.</div></div><div><h3>Conclusions</h3><div>Bare metal stenting across the aortic arch after hemiarch repair in the setting of persistent distal TL compression is a technically viable strategy and may promote long-term aortic remodeling. This treatment strategy may represent another option for treatment of type I AD in patients presenting with distal malperfusion.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 712-717"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713461","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}

{"title":"A New Technique for Aortic Annular and Outflow Enlargement: Combined Y-Incision and Nicks Procedures","authors":"Kosuke Nakamae MD ,&nbsp;Hiroshi Niinami MD, PhD ,&nbsp;Satoru Domoto MD, PhD ,&nbsp;Takeshi Shinkawa MD, PhD ,&nbsp;Kozo Morita MD","doi":"10.1016/j.atssr.2024.04.011","DOIUrl":"10.1016/j.atssr.2024.04.011","url":null,"abstract":"<div><div>In the valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) era, implanting a larger-sized valve during the initial aortic valve replacement is important. For smaller aortic annuli, combining aortic annular and left ventricular outflow tract (LVOT) enlargement is essential. The Y-incision procedure helps achieve implantation of a 2-size larger valve. However, it can lead to size discrepancies between the valve and the LVOT, thus resulting in a residual pressure gradient, and the risk of coronary obstruction after ViV-TAVR remains because the initial surgical valve is implanted tilted inward. To resolve these concerns, we combined the Y-incision and Nicks procedures.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 799-803"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959048","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}

{"title":"Artificial Intelligence: Adult Supervision Required","authors":"Allison L. Weiderhold BA, MS,&nbsp;Lauren M. Barron MD","doi":"10.1016/j.atssr.2024.08.005","DOIUrl":"10.1016/j.atssr.2024.08.005","url":null,"abstract":"","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Page 747"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959459","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}

{"title":"Atypical Carcinoid With Pulmonary Metastasis in an Adolescent","authors":"Ryo Karita MD ,&nbsp;Hironobu Wada MD, PhD ,&nbsp;Yuki Onozato MD, PhD ,&nbsp;Toshiko Kamata MD, PhD ,&nbsp;Hajime Tamura MD, PhD ,&nbsp;Takashi Anayama MD, PhD ,&nbsp;Mina Komuta MD, PhD ,&nbsp;Yuichiro Hayashi MD, PhD ,&nbsp;Ichiro Yoshino MD, PhD ,&nbsp;Shigetoshi Yoshida MD, PhD","doi":"10.1016/j.atssr.2024.05.023","DOIUrl":"10.1016/j.atssr.2024.05.023","url":null,"abstract":"<div><div>Advanced-stage atypical carcinoid tumors are seldom seen in the teenaged population. Comprehensive care, extending beyond mere cancer treatment, is essential. A 16-year-old boy received a diagnosis of a 13-mm nodule in the left S⁵ lung segment with signs suggesting interlobar pleural indentation. A surgical biopsy revealed a neuroendocrine tumor, which led to lingular segmentectomy and lymph node dissection. The pathologic diagnosis was atypical carcinoid with intrapulmonary metastasis, classified as pT3 N0 M0 stage IIB. In addition to oncologic management for the advanced-stage atypical carcinoid, genetic counseling and meticulous mental support were provided. The accumulation of clinical data on teenaged patients with lung cancer is urgently needed.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 655-658"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959551","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}

{"title":"Long-Term Outcomes of the Non-Fenestrated Strategy for Extracardiac Total Cavopulmonary Connection","authors":"Daisuke Takeyoshi MD ,&nbsp;Takeshi Konuma MD, PhD ,&nbsp;Ai Kojima MD ,&nbsp;Kiyohiro Takigiku MD, PhD ,&nbsp;Takamasa Takeuchi MD, PhD ,&nbsp;Hiroyuki Kamiya MD, PhD ,&nbsp;Yorikazu Harada MD, PhD","doi":"10.1016/j.atssr.2024.06.009","DOIUrl":"10.1016/j.atssr.2024.06.009","url":null,"abstract":"<div><h3>Background</h3><div>The discussion of Fontan fenestration is difficult because many institutions have different strategies over time. In our institute, we performed a non-fenestrated Fontan procedure for single-ventricular physiology as our definitive strategy.</div></div><div><h3>Methods</h3><div>Between August 1999 and December 2007, 72 consecutive patients with single-ventricle physiology underwent extracardiac total cavopulmonary connection without fenestration as our definitive strategy. Primary outcomes were Fontan-related events, including death, reoperation, catheter intervention, and postoperative complications such as arrhythmias, protein-losing enteropathy, plastic bronchitis, thrombosis, bleeding, and drainage of pleural effusion after discharge.</div></div><div><h3>Results</h3><div>The median follow-up duration was 15.7 years (interquartile range, 15.3–18.4). The 1-, 2-, 3-, 5-, 10-, and 15-year occurrence of Fontan-related events was 24%, 43%, 44%, 55%, 67%, and 76%, respectively. The 1-, 2-, 3-, 5-, and 10-year occurrence of venovenous collaterals was 16%, 60%, 65%, 72%, and 81%, respectively. Ventricular end-diastolic pressure was higher in patients with venovenous collaterals (median, 5.0 mm Hg; interquartile range, 4.0-7.0 mm Hg) than in those without (median, 3.5 mm Hg; interquartile range, 3.0-4.25 mm Hg) (<em>P</em> = .01). Multivariable Cox regression analysis showed that higher ventricular end-diastolic pressure and younger age at Fontan completion significantly increased the risk of developing venovenous collaterals, with hazard ratios of 1.22 for each (95% CI, 1.052–1.41; <em>P</em> = .0085 and .016, respectively).</div></div><div><h3>Conclusions</h3><div>The occurrence rate of Fontan-related events was acceptable with the non-fenestrated Fontan strategy, whereby venovenous collateral development was common. The results suggest that patients with high ventricle end-diastolic pressure and young patients might benefit from fenestration.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 820-824"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959681","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}

{"title":"Noninflammatory Causes of Pulmonary Edema During Ex Vivo Lung Perfusion","authors":"Jennifer Whiteley MD ,&nbsp;Hongchao Shan MD ,&nbsp;Jonathan C. Yeung MD, PhD","doi":"10.1016/j.atssr.2024.06.013","DOIUrl":"10.1016/j.atssr.2024.06.013","url":null,"abstract":"<div><div>Ex vivo lung perfusion (EVLP) is used to evaluate donor lungs prior to lung transplantation. Development of pulmonary edema during EVLP is generally thought to represent inflammatory breakdown of the air-fluid barrier and these lungs are declined for transplant. We present the case of a donor lung that underwent stapled wedge resection during cold storage for air leak and the subsequent development of profound (∼650 mL) pulmonary edema around the staple line during EVLP. Nevertheless, the edema cleared shortly after implantation. This report illustrates the potential for significant alveolar fluid clearance and sealing of vascular injury after implantation when edema is not caused by inflammatory injury.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 848-850"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959682","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}

{"title":"Robotic Portal Segmentectomy in the Right Middle Lobe After Right Upper Lobectomy","authors":"Ryusuke Sumiya MD, PhD ,&nbsp;Takeshi Matsunaga MD, PhD ,&nbsp;Yukio Watanabe MD, PhD ,&nbsp;Mariko Fukui MD, PhD ,&nbsp;Aritoshi Hattori MD, PhD ,&nbsp;Kazuya Takamochi MD, PhD ,&nbsp;Kenji Suzuki MD, PhD","doi":"10.1016/j.atssr.2024.07.015","DOIUrl":"10.1016/j.atssr.2024.07.015","url":null,"abstract":"<div><div>Although segmentectomy is the standard surgical procedure for small-sized peripheral non-small cell lung cancer, reports on segmentectomy for right middle robe are rare because of the anatomical feature. We report a case of an 81-year-old woman with a history of left S4 segmentectomy, left basal segmentectomy, and right upper lobectomy for multiple primary lung cancer with a part solid nodule in S4a. Owing to the increased volume of the right middle lobe following a right upper lobectomy, a right S4 segmentectomy was performed. In patients with a large right middle lobe or dilated resulting from a previous lung resection, segmentectomy is an option for preserving the lung parenchyma.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"2 4","pages":"Pages 640-642"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959719","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}