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Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Department of Cardiothoracic Surgery, Ruhr-University Hospital Bergmannsheil, Bürkle de-la Camp-Platz 1, Bochum, NRW 44789, Germany.

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary.

Fluroquinolone (FQ) antibiotics have come under increased scrutiny given their recent association with aortic events. While judicious use has been urged in select patient populations such as those with Marfan and Ehlers-Danlos syndromes that have a known predisposition for aortopathy, other at-risk patient populations may remain. Here we describe the atypical delayed-presentation of a type A aortic dissection in a patient with alpha-1 anti-trypsin (A1AT) deficiency and longstanding FQ exposure. Read More

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Santé, France. Electronic address:

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Dept of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Bengaluru.

We are presenting a delayed complication of Amplatzer duct occluder (ADO) where the patient presented with increasing hemoptysis due to ADO eroding the vessel wall and forming a pseudoaneurysm which communicated with the left main bronchus. Though ADO is considered as the safest for catheter based patent ductus arteriosus closures, isolated complication as reported can occur. Just like atrial septal defect device closures, which were considered safe initially and found to be having an erosion incidence of 0. Read More

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.

Background: Patterns of use of older donor lungs within this previously underutilized donor population are poorly characterized. We examined factors associated with the use of older donor lung allografts and factors associated with survival in recipients of these lungs.

Methods: Adult donors in the UNOS registry who donated ≥1 organ for transplantation between 2006-2018 were analyzed and stratified into older (age>55) and younger (age≤55) cohorts. Read More

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Institutions Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Institutions Hôpital militaire principal d'instruction de Tunis, Mont Fleury, 1008 Tunis, Tunisie; Institutions cardio-thoracic surgery department.

Hydatid disease is one of the most widespread and endemic infections causing a substantial health and economic burden. The liver and lungs remain the most affected viscera. We report, herein, the case of 41 years old men with a very atypical presentation: an hydatid cyst of the liver with a huge extension to the mediastinum through the esophagus hiatus . Read More

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, 200 First St. SW, Rochester, MN, 55905. Electronic address:

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Department of Thoracic Surgery, the Third Affiliated Hospital of Kunming Medical University, Kunming, 650105, China.

Owing to the fact that the segmental bronchi and vessels are commonly variable and complicated, it is difficult to correctly identify them. Misidentification of the segmental anatomy could result in the failure of segmentectomy and conversion to the other surgical procedures (such as bisegmentectomy or lobectomy). As a result, we summarized a novel method to identify the target segmental vessels and bronchi by exposing the adjacent segmental anatomy during uniportal video-assisted thoracoscopic (VATS) segmentectomy, which could help to reduce the chance of misidentification. Read More

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Virginia Commonwealth University, Division of Cardiothoracic Surgery, Richmond, VA, USA.

Deglutition syncope is a rare neurally mediated reflex syncope associated with swallowing. It is typically associated with pharyngoesophageal disorders with secondary abnormal vagal reflex causing atrioventricular cardiac block and cerebral hypoperfusion. Diagnosis can be delayed and challenging. Read More

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Cleveland Clinic Foundation, Cleveland, OH.

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Division of Interventional Pulmonology and Thoracic Surgery, Swedish Cancer Institute, Seattle, WA. Electronic address:

Background: Recent studies have identified poor adherence to recommended guidelines in diagnosing and staging patients with non-small cell lung cancer (NSCLC), which has been associated with numerous negative downstream effects. However, these reports are comprised predominantly of large administrative databases with inherent limitations. We aimed to describe guideline-inconsistent care and identify any associated factors within our healthcare system. Read More

Ann Thorac Surg 2020 May 31. Epub 2020 May 31.

Department of Thoracic and Cardiovascular Surgery, University Hospital, Rennes, France.

Ann Thorac Surg 2020 May 30. Epub 2020 May 30.

Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, Yamanashi, Japan.

Ann Thorac Surg 2020 May 29. Epub 2020 May 29.

Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.

Background: The relevance of aortic dissection chronicity to development of stent graft-induced new entry (SINE) is unknown.

Methods: This study enrolled 69 patients who underwent thoracic endovascular aortic repair (TEVAR) for chronic aortic dissection from January 2006 to December 2017 and were followed up for ≥6 months. Their medical records were reviewed retrospectively. Read More

Ann Thorac Surg 2020 May 28. Epub 2020 May 28.

Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.

Background: Geographic origin is cited as a possible factor influencing outcomes of operation for repair or replacement of degenerative mitral valve disease. Our study aimed to identify the potential impact of referral bias on clinical outcomes of mitral valve (MV) surgery.

Methods: We analyzed clinical and echocardiographic information of 2,353 patients undergoing primary or secondary MV surgery for degenerative MV disease. Read More

Ann Thorac Surg 2020 May 27. Epub 2020 May 27.

Swedish Cancer Institute, Division of Thoracic Surgery, 1101 Madison St, Suite 900, Seattle WA 98104.

Background: Patients with locally advanced, non-small cell lung cancer treated with definitive chemoradiotherapy alone often demonstrate persistent or recurrent disease. In the absence of systemic progression, salvage lung resection post-definitive chemoradiotherapy has been utilized as a treatment option. Given the paucity of data, we sought to evaluate the safety and efficacy of salvage pulmonary resections occurring >90 days post-definitive chemoradiotherapy. Read More

Ann Thorac Surg 2020 May 27. Epub 2020 May 27.

Section of Chest Surgery.

Background: Successful surgical treatment of patients with Mycobacterium avium complex pulmonary disease is thought to require complete removal of parenchymal destructive lesions. This study aimed to evaluate the short- and long-term outcomes and the predictors of microbiological recurrence after surgery for Mycobacterium avium complex pulmonary disease.

Methods: We conducted a retrospective review of 184 patients undergoing unilateral lung resection for Mycobacterium avium complex pulmonary disease at a single center in Japan between January 2008 and December 2017. Read More

Ann Thorac Surg 2020 May 27. Epub 2020 May 27.

Division of Cardiac Surgery, Department of Surgery. Electronic address:

We present the successful use of surgical embolectomy (SE) without systemic anticoagulation to treat a complicated case of pulmonary embolism (PE). The patient presented with an embolic cerebrovascular accident and subsequently developed a massive PE. Due to risk of hemorrhagic transformation, the decision was made to proceed with emergent SE on VA-ECMO support without anticoagulation. Read More

Ann Thorac Surg 2020 May 27. Epub 2020 May 27.

Department of Pediatrics, Division of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati OH.

Background: Fluid overload contributes to poor outcomes after neonatal cardiac surgery. The optimal strategy to mitigate fluid overload related morbidity is unknown. The utility of prophylactic peritoneal dialysis remains controversial. Read More

Ann Thorac Surg 2020 May 24. Epub 2020 May 24.

Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1489, Houston, TX 77030. Electronic address:

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Department of cardiovascular surgery, Kyushu university hospital. Electronic address:

Most patients with repaired tetralogy of Fallot (TOF) survive to adulthood and suffer from residual right ventricular pathology, mostly pulmonary regurgitation. Pulmonary valve replacement (PVR) is a procedure of choice to alleviate right ventricular dilatation and pulmonary regurgitation. Resternotomy is the standard approach for PVR in patients who have undergone TOF repair. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Department of Surgery, Division of Pediatric Cardiothoracic Surgery, Children's Healthcare of Atlanta, Atlanta, Georgia.

Background: Anomalous aortic origin of a coronary artery (AAOCA) is associated with sudden cardiac death. High risk characteristics are most commonly assessed using two dimensional (2D) echocardiogram (echo) or cardiac computed tomography (CT). We hypothesize that these characteristics will be more accurately assessed when they are presented in the form of a 3D digital model. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Department of Cardiothoracic Surgery, National Heart Centre Singapore, SINGAPORE.

Isolated chylopericardium after cardiac surgery is extremely rare, but potentially fatal. We present an unusual case of late postoperative chylopericardium causing cardiac tamponade 6 weeks after mitral valve repair, tricuspid annuloplasty and left atrial appendage closure via median sternotomy. Emergent pericardiocentesis was performed. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Cardiac Surgery Unit, Department of Experimental and Clinical Medicine, University "Magna Graecia" , Catanzaro, Italy.

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Department of Surgery, Division of Thoracic Surgery, Mayo Clinic, Rochester, MN. Electronic address:

Background: Patient-reported reflux is one of the most common complaints after esophagectomy. This study aimed to determine predictors of patient-reported reflux and if a preserved pylorus would protect from symptomatic reflux.

Methods: A prospective clinical study recorded patient-reported reflux after esophagectomy from August 2015 to July 2018. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Department of Cardiothoracic Surgery, University of Louisville. Electronic address:

Background: The presence of significant atrioventricular valve (AVV) regurgitation results in unfavorable conditions that affect the success of single ventricle (SV) multistage palliation. We report our institution's AVV repair experience.

Methods: We examined incidence of AVV repair in 603 infants who underwent initial SV palliation surgery from 2002-12. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY 14642. Electronic address:

Background: Venous-arterial extracorporeal membrane oxygenation (VA-ECMO) undoubtedly saves many lives, but is associated with a high degree of patient morbidity, mortality, and resource utilization. We aimed to develop a machine learning algorithm to augment clinical decision making related to VA-ECMO.

Methods: Patients supported by VA-ECMO at a single institution from May 2011 to October 2018 were retrospectively reviewed. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address:

Complete surgical resection is the most critical factor to achieve better long-term outcomes in treating primary cardiac sarcomas, however, it is oftentimes hampered when there is extensive tumor involvement into important cardiac apparatus. Here, we report a case of successful complete resection of a cardiac sarcoma infiltrating the right atrio-ventricle, tricuspid valve and right coronary artery. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Division of Cardiac Surgery, University of California, Los Angeles, Los Angeles, California. Electronic address:

Background: The objective of the present study was to characterize practical utilization trends and outcomes for intra-aortic balloon pump (IABP) and percutaneous left ventricular assist device (pVAD) in cardiogenic shock at a national level.

Methods: An analysis of all adult patients admitted non-electively for cardiogenic shock from January 2008 through December 2017 was performed using the National Inpatient Sample (NIS). Trends of inpatient IABP and pVAD use were analyzed using survey weighted estimates and the modified Cochran-Armitage test for significance. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Cardiac anesthesia, KIMS, Trivandrum, India.

Aortic injuries are notoriously lethal particularly when associated with concomitant injuries. We describe the evaluation and management of a polytrauma patient with transverse arch transection which was complicated by dissection of both common carotid arteries. He was managed with aortic arch replacement and reimplanatation of innominate and left common carotid arteries with an additional graft from ascending aorta to the right common carotid artery. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA; Dept. of Pediatrics, Harvard Medical School, Boston, MA, USA. Electronic address:

Background: Aortic valve neo-cuspidization (AVNeo, Ozaki procedure) has excellent mid-term results in adults. Outcomes in patients with a small native aortic annulus are unknown. We report early outcomes in young patients with small native aortic valve annuli. Read More

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Division of Cardiothoracic Surgery, Ochsner Medical Center, New Orleans, Louisiana.

Background: While literature shows rigid plate fixation has superior outcomes over wire cerclage techniques, a patient population clearly benefitting from initial sternal plating over standard closure has not been identified. Data on plating as primary sternal closure in the morbidly obese patient remains sparse.

Methods: A single-center retrospective study was performed on 564 consecutive patients undergoing complete median sternotomy from July 2014 to July 2017. Read More

Ann Thorac Surg 2020 May 21. Epub 2020 May 21.

Department of Cardiac Surgery, Marie Lannelongue Hospital, Le Plessis-Robinson, 133 Avenue de la Résistance Le Plessis-Robinson, 92350, France. Electronic address:

Ann Thorac Surg 2020 Jun;109(6):1953

Ann Thorac Surg 2020 May 20. Epub 2020 May 20.

Department of Surgery, Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore MD. Electronic address:

An anomalous right coronary artery arising from the left coronary sinus is a rare anatomic variant. Here, we report a patient who presented with an acute type A dissection and underwent successful aortic root reconstruction with resuspension of the aortic valve and neomedia creation in the presence of an anomalous right coronary artery with a good clinical outcome. Read More

Ann Thorac Surg 2020 May 20. Epub 2020 May 20.

Department of Cardiac Surgery, Lens Hospital, Lens, France; Bois Bernard Private Hospital, Ramsay Générale de Santé, Bois Bernard, France.

The Ross operation is the gold standard for aortic valve replacement (AVR) in young patients as it is a durable and anticoagulation-free alternative to mechanical AVR. Careful assessment of the pulmonary valve is critical as it should become a durable neoaortic valve. Here we report the case of a patient in whom the pulmonary autograft was jeopardized by a large doubly committed ventricular septal defect (VSD), which did not offer sufficient autologous tissue for the proximal suture line. Read More

Ann Thorac Surg 2020 May 20. Epub 2020 May 20.

Department of Anaesthesia and Critical Care, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Surgery for infective endocarditis in the pulmonary position is an effective method of treatment despite a very uncommon pathology and few operations being performed. We present an adult male with right sided infective endocarditis where pulmonary valve cusps were almost completely damaged. Pulmonary valve was successfully reconstructed using glutaraldehyde treated autologous pericardium by Ozaki technique. Read More

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Background: Ultrasound guidance has resulted in a continuous evolution in techniques for pain control for video assisted thoracoscopic surgery (VATS). The objective of this study was to compare Erector Spinae Plane blocks (ESP) with intercostal blocks (ICB) as part of multi-modal analgesia in quality of postoperative pain control and preservation of pulmonary function after VATS.

Methods: A consecutive cohort of patients undergoing elective VATS were enrolled in the study and divided into the ESP and ICB block groups. Read More

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

Duke University Medical Center, Department of Surgery, Box 3051 DUMC, Durham, NC 27710.

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

From the Department of Cardiac Surgery, Medical University of Innsbruck.

Remote access perfusion for minimally invasive mitral surgery is commonly achieved by femoro-femoral bypass. We describe the use of the carotid artery as an inflow in two patients with severe calcifications of the abdominal aorta and the iliac arteries who underwent minimally invasive mitral and tricuspid valve repair. The easy and fast access to the vessel and the lack of interference with the transthoracic clamp and the scope are the major advantages of the carotid compared other alternatives such as the axillary artery. Read More

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

Division of Cardiac Surgery, University of Ottawa Heart Institute, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y4W7, Canada. Electronic address:

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030. Electronic address:

Background: Mutations in the serine-threonine kinase LKB1/STK11 have been implicated in mediating resistance to checkpoint blockade among patients with advanced lung adenocarcinoma. We sought to examine the associations between clinicopathologic characteristics, tumor LKB1 expression, features of the immune microenvironment, and postoperative prognosis among patients with early-stage lung adenocarcinoma undergoing surgical therapy.

Methods: Formalin-fixed, paraffin-embedded specimens of patients undergoing resection of stage I-III, chemotherapy-naïve adenocarcinomas (1997-2008) were analyzed using tissue microarray sectioning. Read More

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

West Virginia University, Morgantown WV; Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV.

Ann Thorac Surg 2020 May 19. Epub 2020 May 19.

Meijer Heart and Vascular Institute, Center for Structural and Transcatheter Heart Valve Therapies, Spectrum Health, Grand Rapids, Michigan.

Background: Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) is acceptable in patients high-risk for reoperation. Studies suggest that ViV TAVR in stentless valves may be technically more challenging. This study sought to evaluate midterm outcomes for ViV TAVR in the degenerative Freestyle stentless bioprosthesis. Read More

Ann Thorac Surg 2020 May 18. Epub 2020 May 18.

Division of Cardiac Surgery, University of Ottawa Heart Institute. Electronic address:

Background: The left internal thoracic artery (LITA) to left anterior descending (LAD) artery bypass remains the gold standard for coronary artery bypass graft (CABG) surgery. With the advent of bilateral ITA (BITA) grafting, optimal bypass configuration to the LAD is unclear. The objective of this study was to compare clinical outcomes between LITA-LAD and RITA-LAD configurations in BITA grafting. Read More

Ann Thorac Surg 2020 May 18. Epub 2020 May 18.

Dept of Cardiac Surgery, GVM Care and Research, Anthea Hospital, Bari (BA), Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy.

We described an alternative technique for ascending aorta replacement with sinotubular junction reduction and stabilization. This technique is performed by suspension of the three commissures, invagination of the aortic Dacron graft and advancing the graft into the ventricles. The proximal anastomosis is performed with 2 suture lines. Read More

Ann Thorac Surg 2020 May 18. Epub 2020 May 18.

Division of Cardiac Surgery, University of California, Los Angeles, Los Angeles, California. Electronic address:

Background: Autoimmune connective tissue diseases (CTD) are associated with accelerated atherosclerosis and inflammation, while often requiring immunosuppression. Large scale outcomes of coronary artery bypass graft (CABG) surgery in this population have not been reported thus far. This study characterized trends in utilization of CABG in patients with CTD and the impact of the disease on mortality, in-hospital complications, length of stay (LOS) and costs. Read More

Ann Thorac Surg 2020 May 18. Epub 2020 May 18.

Vascular and Endovascular Surgery, Fondazione I.R.C.C.S. Policlinico San Matteo, P.le Golgi 19 27100 Pavia, ITALY.

Ann Thorac Surg 2020 May 10. Epub 2020 May 10.

Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Surgery, Northwestern University Feinberg School of Medicine. Electronic address:

Background: Given recent reports of percutaneous closure of sinus venosus atrial septal defects (SVASD), we reviewed our experience with surgical repair. Due to the high incidence of arrhythmias with the two-patch technique, since 2001 we have used either one-patch repairs or the Warden procedure.

Methods: A retrospective review was performed of pediatric patients undergoing SVASD at our institution from 1/1/1990 to 7/1/2018. Read More