MedWorm: Cardiovascular & Thoracic Surgery Top 20

Tributes to cardiac surgical pioneers

The Journal of Thoracic and Cardiovascular Surgery — Fri, 18 Nov 2011 11:18:33 +0100

“The only way to predict the future … is to invent it yourself.”—Norman E. Shumway, Jr In this issue, you will notice an interesting article that should have been printed 24 years ago: the presidential address of Norman E. Shumway, Jr, the 67th president of the American Association for Thoracic Surgery. His address titled, “Some thoughts from the other side of the table, or the last presidential address” is one of great insight, humor, and education. This address has been lying fallow for some time because it was never really completed and had some interesting sections that required carefully editing. His daughter, Dr Sara Shumway, a cardiac surgeon at the University of Minnesota, did a great job editing her father’s manuscript and was in favor of us publishing this article ...

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2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement

Catheterization and Cardiovascular Interventions — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Catheterization and Cardiovascular Interventions)

Human immunodeficiency virus infection as a prognostic factor in surgical patients with non-small cell lung cancer.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:23:10 +0100

CONCLUSIONS: The HIV-infected NSCLC patients have more postoperative complications, rapid progression to disease recurrence, and poorer postoperative survival. Optimizing immune status before surgery and careful patient selection based on diffusion capacity of lung for carbon monoxide may improve patient outcomes. PMID: 22269705 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Segmentectomy simulation using a virtual three-dimensional safety margin.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:12:53 +0100

We report 2 cases of primary lung cancer for which we performed segmentectomy based on preoperative simulations by 3D-CTA with virtual 3D safety margins. We found this technique easy to use for simulations and useful for safely performing segmentectomy for small tumors in lung cancer. PMID: 22269767 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Subcarinal Node Metastasis in Thoracic Esophageal Squamous Cell Carcinoma [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Longer tumor length, higher pathologic T stage, lower histologic grade, and positive lymph node metastases of other groups are associated with a higher frequency of subcarinal node metastasis. Subcarinal node metastasis indicates worse prognosis of patients with thoracic esophageal squamous cell carcinoma compared with paraesophageal node metastasis. (Source: The Annals of Thoracic Surgery)

Trends in isolated coronary artery bypass grafting: An analysis of the Society of Thoracic Surgeons adult cardiac surgery database

The Journal of Thoracic and Cardiovascular Surgery — Thu, 19 Jan 2012 09:10:16 +0100

Conclusions: Over the past decade, the risk profile of patients undergoing CABG has changed, with fewer smokers, more diabetic patients, and better medical therapy characterizing patients referred for surgical coronary revascularization. The left internal thoracic artery is nearly universally used and outcomes have improved substantially, with a significant decline in postoperative mortality and morbidity. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Lung cancer cell invasion and expression of intercellular adhesion molecule-1 (ICAM-1) are attenuated by secretory phospholipase A2 inhibition

The Journal of Thoracic and Cardiovascular Surgery — Thu, 19 Jan 2012 09:10:17 +0100

Conclusions: sPLA2 plays a significant role in mediating the inflammatory signals that induce ICAM-1 expression in lung cancer cells. Inhibition of the enzyme can significantly decrease ICAM-1 expression and subsequent cancer cell invasion. This lays the groundwork for further investigation into the cellular mechanisms of sPLA2 and its role in lung cancer. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Bronchiolitis obliterans organizing pneumonia due to titanium nanoparticles in paint.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:17:16 +0100

We present a case of a 58-year-old man who experienced Bronchiolitis obliterans organizing pneumonia after a 3-month exposure to polyester powder paint. Mineralogical analysis by transmission electron microscopy of a pulmonary sample and the polyester powder paint he was exposed to showed the presence of titanium dioxide nanoparticles in both. We suggest that exposure to titanium dioxide nanoparticles should be added to the etiology of Bronchiolitis obliterans organizing pneumonia. PMID: 22269741 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Integrated surgical protocol for the treatment of the infected diabetic foot.

The Journal of Cardiovascular Surgery — Wed, 11 Jan 2012 12:56:15 +0100

Authors: Caravaggi C Abstract Diabetes is a chronic disease with a worldwide increasing trend. Feet complication, closely related to neuropathy and obstructive peripheral vascular disease, are responsible for more than 1 million of leg amputations every year. Foot infection can dramatically improve the risk of amputation. Although many ulcer classification systems have been proposed to stratify the severity of infectious process the problem of the definition of a correct therapeutic approach to different clinical pictures still remains unresolved. A diabetic foot triage and an integrated surgical protocol are proposed to try identifying a diagnostic flowchart and a step-by-step surgical protocol that can be applied in the treatment of diabetic foot infection. Goals and technical as...

Type B aortic dissection after the use of tadalafil.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:18:33 +0100

This report and three other cases add a new dimension to the known predisposing factors such as chronic systemic hypertension, hereditary connective tissue diseases- and congenital aortic valve diseases. However, the precise role of phosphodiesterase type 5 inhibitors in the pathophysiology of aortic dissection remains unknown. PMID: 22269733 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Intrathymic primary intrathoracic goiter in a patient with breast malignancy.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:13:04 +0100

We report a rare case of an intrathymic primary intrathoracic goiter. The patient with newly diagnosed breast carcinoma was also known to have a distinct large anterior mediastinal mass. This was removed via a median sternotomy, after a thorascopic biopsy had been performed in the past but a diagnosis had not been reached. A discussion relating to the extremely rare occurrence of intrathymic ectopic thyroid tissue and the surgical treatment of primary intrathoracic goiters is included. PMID: 22269766 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Atypical presentation and transabdominal treatment of chylothorax complicating esophagectomy for cancer

Journal of Cardiothoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

We report a case of a young adult male who underwent neoadjuvant chemoradiationtherapy followed by Ivor-Lewis esophagectomy for a squamous-cell carcinoma of the distal esophagus. During the postoperative course the patient presented recurrent episodes of hemodynamic instability mimicking cardiac tamponade, secondary to compression of the left pulmonary vein and the left atrium by a mediastinal chylocele. Mediastinal drainage and ligation of the cisterna chyli and the thoracic duct was successfully performed through a transhiatal approach. (Source: Journal of Cardiothoracic Surgery)

Intrathymic Primary Intrathoracic Goiter in a Patient With Breast Malignancy [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Anemia Before Coronary Artery Bypass Surgery as Additional Risk Factor Increases the Perioperative Risk [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 30 Aug 2011 23:00:00 +0100

Conclusions In our patient group undergoing CABG surgery, preoperative anemia increased the mortality risk by 3.4, even when taking the higher perioperative risk of anemic patients into consideration. (Source: The Annals of Thoracic Surgery)

Influence of temperature management on neurocognitive function in biological aortic valve replacement. A prospective randomized trial.

The Journal of Cardiovascular Surgery — Wed, 11 Jan 2012 12:54:37 +0100

CONCLUSION: Normothermic temperature management during CPB is non-inferior to hypothermic in means of neuroprotection. Since patients after biological aortic valve replacement show a subclinical but measurable cognitive deficit up to four months after surgery, other factors have to be addressed to add further benefit to the extremely good results of open biological AVR. PMID: 22231536 [PubMed - in process] (Source: The Journal of Cardiovascular Surgery)

Systematic approach to ruptured abdominal aortic aneurysm in the endovascular era: Intention-to-treat eEVAR protocol.

The Journal of Cardiovascular Surgery — Wed, 11 Jan 2012 12:55:06 +0100

Authors: Willigendael EM, Cuypers PW, Teijink JA, Van Sambeek MR Abstract Emergency endovascular aneurysm repair (eEVAR) for ruptured abdominal aortic aneurysms (rAAA) is still a relatively new treatment option. A pre-defined strategy of an eEVAR first approach for rAAA is associated with improved mortality rates. After establishing and implementing the Intention-to-treat eEVAR protocol for rAAAs the mortality and morbidity rates improved significantly. The presented Intention-to-treat eEVAR protocol starts at the first telephone call to the ambulance department and lasts until the post-operative care unit. The protocol involves the close collaboration between the ambulance department, vascular surgeon, emergency department physicians, anaesthesiologists, operating room staff and, ...

Historical perspectives of The American Association for Thoracic Surgery: Alfred Blalock (1899–1964)

The Journal of Thoracic and Cardiovascular Surgery — Thu, 19 Jan 2012 09:10:16 +0100

Alfred Blalock, the 30th president of The American Association for Thoracic Surgery (AATS), was born on April 5, 1899, in the small town of Culloden, Georgia. Located in Monroe County in central Georgia, Culloden is approximately 0.8 square miles in size and, according to the United States Census of 1900, had a population of 334. Blalock was the eldest of 5 children born to George Z. Blalock and Martha (Davis) Blalock. The elder Blalock was a merchant and the owner of a cotton plantation. Often referenced as a firm disciplinarian, Blalock’s father placed a significant value on education. According to his sister, Alfred would “…rather [his] mother use the hairbrush on him than [his] father look at him hard.” When Alfred was a youth, the family moved to nearby Jonesboro owing to his ...

Comparative long‐term efficacy and safety of drug‐eluting stent versus coronary artery bypass grafting in ostial left main coronary artery disease

Catheterization and Cardiovascular Interventions — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions: DES implantation for ostial LMCA lesions showed similar 5‐year outcomes of death, major adverse events, and TVR compared with CABG. Although meticulous adjustments decreased baseline difference between the two treatments, the absence of statistical significance could be attributable to the size of the study sample and hidden bias. © 2012 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

The challenging topic of diabetic foot revascularization: does the angiosome-guided angioplasty may improve outcome.

The Journal of Cardiovascular Surgery — Wed, 11 Jan 2012 12:56:38 +0100

Authors: Alexandrescu V, Hubermont G Abstract The angiosome model was first pioneered by Jan Taylor in 1987 by his influential anatomical works in the plastic reconstructive surgery field. The concept depicts the human body into three-dimensional blocks of tissue, fed by specific arterial and venous irrigation sources, the "angiosomes". Adjacent angiosomes are linked by a vast compensatory collateral web "the choke vessels". This collateral network provides a remarkable "rescue system" in non-atherosclerotic and non-diabetic patients. However, it could be dramatically damaged in chronic limb ischemia (CLI) subjects witnessing miscellaneous systemic arterial disease. The angiosome concept may provide useful information on the human vascular anatomy and related pathology, with specif...

Successful Treatment of Novel H1N1 Influenza related Fulminant Myocarditis with Extracorporeal Life Support

Journal of Cardiothoracic Surgery — Tue, 20 Dec 2011 05:00:00 +0100

We report a case of fulminant myocarditis associated with this virus treated successfully using extra-corporal membrane oxygenator. (Source: Journal of Cardiothoracic Surgery)