Annals of thoracic surgery short reports最新文献

英文中文

Psychiatric Comorbidities and Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.013

Jesse York MS , James O’Toole MD , Andrea Makowski BS , Alyssa Woodward MD , Rebecca Suk MS , Roman Petrov MD, PhD , Charles Bakhos MD, MS , Doraid Jarrar MD, MHCI , Sai Yendamuri MD, MBA

Background

The association between psychiatric comorbidities (PCs) and long-term survival after lobectomy for early-stage non-small cell lung cancer is unknown. We sought to investigate this relationship using the Surveillance, Epidemiology, & End-Results (SEER)-Medicare registry.

Methods

Data for all patients in the SEER-Medicare registry who underwent lobectomy for stage I non-small cell lung cancer from 2007 to 2014 were included. Those older than 80 years at time of diagnosis, with multiple cancers, or histology other than adenocarcinoma or squamous cell carcinoma were excluded. Patients diagnosed with depression, anxiety, bipolar disorder, schizophrenia, other (non-schizophrenic) psychotic disorders, unspecified mood disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, or substance use disorder prior to lung cancer diagnosis were considered to have a PC. Survival of patients with PC was compared to controls using univariable and multivariable analysis adjusting for age, sex, race, stage (IA/IB), histology, surgical approach, and Charlson Comorbidity Index.

Results

Of 5516 patients, 1369 (24.8%) had PCs. Patients with PCs were more likely to be younger (P < .001), female (P < .001), white (P < .001), and have stage IA cancer (P < .001). PC was associated with shorter survival (median, 2478 vs 2820 days; P = .002). Multivariable analysis retained PC in the final model, with a hazard ratio of 1.10 (P < .001). Subgroup analysis revealed that this survival difference was driven by differences in survival of patients with schizophrenia (P < .001) and alcohol use disorder (P = .006).

Conclusions

Select psychiatric comorbidities are associated with reduced survival after lobectomy for early-stage non-small cell lung cancer.

{"title":"Psychiatric Comorbidities and Survival After Lobectomy for Stage I Non-Small Cell Lung Cancer","authors":"Jesse York MS , James O’Toole MD , Andrea Makowski BS , Alyssa Woodward MD , Rebecca Suk MS , Roman Petrov MD, PhD , Charles Bakhos MD, MS , Doraid Jarrar MD, MHCI , Sai Yendamuri MD, MBA","doi":"10.1016/j.atssr.2024.07.013","DOIUrl":"10.1016/j.atssr.2024.07.013","url":null,"abstract":"<div><h3>Background</h3><div>The association between psychiatric comorbidities (PCs) and long-term survival after lobectomy for early-stage non-small cell lung cancer is unknown. We sought to investigate this relationship using the Surveillance, Epidemiology, & End-Results (SEER)-Medicare registry.</div></div><div><h3>Methods</h3><div>Data for all patients in the SEER-Medicare registry who underwent lobectomy for stage I non-small cell lung cancer from 2007 to 2014 were included. Those older than 80 years at time of diagnosis, with multiple cancers, or histology other than adenocarcinoma or squamous cell carcinoma were excluded. Patients diagnosed with depression, anxiety, bipolar disorder, schizophrenia, other (non-schizophrenic) psychotic disorders, unspecified mood disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, or substance use disorder prior to lung cancer diagnosis were considered to have a PC. Survival of patients with PC was compared to controls using univariable and multivariable analysis adjusting for age, sex, race, stage (IA/IB), histology, surgical approach, and Charlson Comorbidity Index.</div></div><div><h3>Results</h3><div>Of 5516 patients, 1369 (24.8%) had PCs. Patients with PCs were more likely to be younger (<em>P</em> < .001), female (<em>P</em> < .001), white (<em>P</em> < .001), and have stage IA cancer (<em>P</em> < .001). PC was associated with shorter survival (median, 2478 vs 2820 days; <em>P</em> = .002). Multivariable analysis retained PC in the final model, with a hazard ratio of 1.10 (<em>P</em> < .001). Subgroup analysis revealed that this survival difference was driven by differences in survival of patients with schizophrenia (<em>P</em> < .001) and alcohol use disorder (<em>P</em> = .006).</div></div><div><h3>Conclusions</h3><div>Select psychiatric comorbidities are associated with reduced survival after lobectomy for early-stage non-small cell lung cancer.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 138-143"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511805","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

Left Anterior Mini-Thoracotomy for Adult Complicated Subarterial Ventricular Septal Defect

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.027

Sun Pan MD, PhD , Hongqiang Zhang MD , Chunsheng Wang MD

Lack of consensus remains for the minimally invasive surgical repair of adult subarterial ventricular septal defects, and the technique has rarely been reported for cases complicated by other cardiac anomalies. We describe a left anterior mini-thoracotomy through the third intercostal incision in an adult woman for combined subarterial ventricular septal defect repair and right ventricular outflow tract obstruction relief. We consider this minimally invasive technique a balanced approach for correction of a complicated subarterial ventricular septal defect in adults.

引用次数: 0

Critical Considerations on DO2 and Postoperative Outcomes in Cardiopulmonary Bypass

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.024

Ignazio Condello PhD

引用次数: 0

Salvage Surgery for Thoracic SMARCA4-Deficient Undifferentiated Tumor

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.08.008

Masatoshi Kanayama MD, PhD , Akihiro Taira MD , Katsuma Yoshimatsu MD , Hiroki Matsumiya MD , Masataka Mori MD, PhD , Masaru Takenaka MD, PhD , Koji Kuroda MD, PhD , Aya Nawata MD, PhD , Fumihiro Tanaka MD, PhD

Thoracic SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) may be effectively managed with immune checkpoint inhibitors; however, the management of posttreatment exacerbations remains uncertain. A 48-year-old man underwent chemotherapy (cisplatin and pemetrexed) along with PD-L1 and CTLA-4 inhibitors, resulting in significant improvement. Subsequently, maintenance therapy was initiated but discontinued because of drug-induced pneumonia. Although prednisone treatment resolved the pneumonia, salvage surgery was performed for exacerbation of an enlarged chest tumor and lymph nodes. No additional postoperative treatment was administered, and the patient has completed 2.5 years of treatment. This case highlights the potential efficacy of salvage surgery in the management of SMARCA4-UT exacerbations.

引用次数: 0

Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.09.011

Jennifer Livschitz MD, MS , Joshua Melamed MD , Britton Donato MD , Amy Yoonjin Lee MD , Huaying Dong BS , Aniko Szabo PhD , William B. Tisol MD , Paul L. Linsky MD , Mario G. Gasparri MD , David W. Johnstone MD

Background

Transcervical endoscopic esophageal mobilization (TEEM) is an approach to transhiatal esophagectomy that aims to minimize blood loss and decrease the operative time commonly associated with traditional transhiatal technique.

Methods

A retrospective chart review was conducted on patients who underwent TEEM esophagectomy between 2009 and 2020. Baseline characteristics, perioperative outcomes, and postoperative complications were recorded. To report survival, a Kaplan-Meier survival plot was developed using SAS software (SAS Institute).

Results

A total of 241 patients underwent TEEM esophagectomy. The mean operative time was 185.1 ± 59.3 minutes, blood loss was 251.4 ± 212.3 mL, the number lymph nodes dissected was 13.6 ± 6.2, and the length of stay was 11.9 ± 8.5 days. In the postoperative setting, 68 (28.2%) patients experienced hoarseness, 62 (25.7%) had postoperative atrial fibrillation, 30 (12.4%) had an anastomotic leak, and 12 (4.6%) experienced chylothorax. The overall 30- and 90-day mortality rates were 2.1% (5 of 241) and 4.6% (11 of 241), respectively. The median overall survival was 2.36 years, with 60% 3-year survival and 40% 5-year survival.

Conclusions

TEEM esophagectomy is a safe approach with acceptable postoperative morbidity and mortality and shorter operative times compared with historical norms.

{"title":"Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy","authors":"Jennifer Livschitz MD, MS , Joshua Melamed MD , Britton Donato MD , Amy Yoonjin Lee MD , Huaying Dong BS , Aniko Szabo PhD , William B. Tisol MD , Paul L. Linsky MD , Mario G. Gasparri MD , David W. Johnstone MD","doi":"10.1016/j.atssr.2024.09.011","DOIUrl":"10.1016/j.atssr.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><div>Transcervical endoscopic esophageal mobilization (TEEM) is an approach to transhiatal esophagectomy that aims to minimize blood loss and decrease the operative time commonly associated with traditional transhiatal technique.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted on patients who underwent TEEM esophagectomy between 2009 and 2020. Baseline characteristics, perioperative outcomes, and postoperative complications were recorded. To report survival, a Kaplan-Meier survival plot was developed using SAS software (SAS Institute).</div></div><div><h3>Results</h3><div>A total of 241 patients underwent TEEM esophagectomy. The mean operative time was 185.1 ± 59.3 minutes, blood loss was 251.4 ± 212.3 mL, the number lymph nodes dissected was 13.6 ± 6.2, and the length of stay was 11.9 ± 8.5 days. In the postoperative setting, 68 (28.2%) patients experienced hoarseness, 62 (25.7%) had postoperative atrial fibrillation, 30 (12.4%) had an anastomotic leak, and 12 (4.6%) experienced chylothorax. The overall 30- and 90-day mortality rates were 2.1% (5 of 241) and 4.6% (11 of 241), respectively. The median overall survival was 2.36 years, with 60% 3-year survival and 40% 5-year survival.</div></div><div><h3>Conclusions</h3><div>TEEM esophagectomy is a safe approach with acceptable postoperative morbidity and mortality and shorter operative times compared with historical norms.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 201-205"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512551","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

The Ligament of Marshall: Far From Vestigial!

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.09.001

Raghav Chandra MD , Jasmina Ehab MD , Madhuri Nagaraj MD , Suresh Keshavamurthy MD

Background

The ligament of Marshall (LOM) is a vestigial fold of the left atrium that contains the remnant left cardinal vein, muscle bundles, and nerve fibers. Despite its description as an embryologic remnant, the LOM carries significant clinical importance as an important focus for atrial fibrillation propagation as well as a therapeutic target.

Methods

In this review, we discuss the embryologic origins of the LOM, its physiology and importance in atrial fibrillation pathogenesis, as well as the role of targeting and ablating the LOM surgically during concomitant cardiac surgery including lung transplantation.

Results

The LOM, particularly its distal segment, is an important focus for atrial fibrillation as both a primary trigger as well as an accessory bundle for signal propagation. It is a key target for electrophysiologic therapies including radiofrequency and alcohol-based ablative strategies. The LOM is also a crucial target for surgical ablation while addressing the left atrial lesion sets. This is often performed concomitantly with other cardiac surgical operations and may play an important role in reducing the risk of postoperative atrial fibrillation after lung transplantation.

Conclusions

Far from just a vestigial structure, the ligament of Marshall remains an important focus for paroxysmal atrial fibrillation and is a potent therapeutic target for both electrophysiologic and surgical approaches.

背景马歇尔韧带（LOM）是左心房的残余褶皱，包含残余的左心静脉、肌束和神经纤维。尽管马歇尔韧带被描述为胚胎残余物，但作为心房颤动传播的一个重要焦点和治疗靶点，它具有重要的临床意义。方法在这篇综述中，我们讨论了 LOM 的胚胎学起源、其生理学和在心房颤动发病机制中的重要性，以及在同时进行的心脏手术（包括肺移植）中以 LOM 为目标并对其进行消融的作用。它是包括射频和酒精消融策略在内的电生理疗法的关键靶点。LOM 也是手术消融的关键靶点，同时还能解决左心房病变问题。这通常与其他心脏外科手术同时进行，并可能在降低肺移植术后心房颤动的风险方面发挥重要作用。结论马歇尔韧带绝不仅仅是一个残余结构，它仍然是阵发性心房颤动的重要病灶，也是电生理学和外科手术方法的有效治疗靶点。

{"title":"The Ligament of Marshall: Far From Vestigial!","authors":"Raghav Chandra MD , Jasmina Ehab MD , Madhuri Nagaraj MD , Suresh Keshavamurthy MD","doi":"10.1016/j.atssr.2024.09.001","DOIUrl":"10.1016/j.atssr.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>The ligament of Marshall (LOM) is a vestigial fold of the left atrium that contains the remnant left cardinal vein, muscle bundles, and nerve fibers. Despite its description as an embryologic remnant, the LOM carries significant clinical importance as an important focus for atrial fibrillation propagation as well as a therapeutic target.</div></div><div><h3>Methods</h3><div>In this review, we discuss the embryologic origins of the LOM, its physiology and importance in atrial fibrillation pathogenesis, as well as the role of targeting and ablating the LOM surgically during concomitant cardiac surgery including lung transplantation.</div></div><div><h3>Results</h3><div>The LOM, particularly its distal segment, is an important focus for atrial fibrillation as both a primary trigger as well as an accessory bundle for signal propagation. It is a key target for electrophysiologic therapies including radiofrequency and alcohol-based ablative strategies. The LOM is also a crucial target for surgical ablation while addressing the left atrial lesion sets. This is often performed concomitantly with other cardiac surgical operations and may play an important role in reducing the risk of postoperative atrial fibrillation after lung transplantation.</div></div><div><h3>Conclusions</h3><div>Far from just a vestigial structure, the ligament of Marshall remains an important focus for paroxysmal atrial fibrillation and is a potent therapeutic target for both electrophysiologic and surgical approaches.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 253-257"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512507","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

Primary Sternal Leiomyosarcoma 原发性胸骨骨髓肉瘤

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.006

Marcus Rossi BS , Frank DiSilvio MD , Joseph Sahagun MD , David Ridder MD , Tyler Evans MD , Richard Anderson MD

We report the case of a primary leiomyosarcoma of the sternum in a 70-year-old man that was discovered incidentally during prostate cancer staging with positron emission tomography combined with computed tomography. Interventional radiology biopsied the lesion; pathologic examination showed spindle cells, indicating probable leiomyosarcoma. No primary site was found on contrast computed tomography, thus suggesting that the tumor was primary rather than metastatic. Given the tumor’s location and mortality risk, the patient underwent a sternotomy and reconstruction with methyl methacrylate, followed by an uneventful recovery. This case underlines a rare leiomyosarcoma presentation, constituting less than 0.7% of all primary malignant bone tumors, noted for its unusual location and rarity.

引用次数: 0

Incidence and Risk Factors for Permanent Pacemaker Implantation After Tricuspid Valve Repair

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.08.003

Jae Woong Choi MD, PhD , Muath Bishawi MD, PhD , Carmelo Milano MD , Jeffrey Gaca MD , Keith Carr BS , Andrew Wang MD , Donald D. Glower MD

Background

Although the likelihood of needing a permanent pacemaker (PPM) after tricuspid valve (TV) repair has been thought to be low compared with TV replacement, the incidence and determinants are controversial. This study aimed to evaluate the incidence and risk factors for PPM implantation after TV repair.

Methods

A total of 1237 consecutive patients undergoing TV repair from 1997 to 2019 were reviewed using a prospectively maintained database, and 1058 patients were enrolled.

Results

Incidence of PPM implantation was 10.3% (n = 109). Median time to PPM implantation was 7 (range, 6-9) days. Indications for PPM implantation were heart block (n = 62, 56.9%), junctional or sinus bradycardia (n = 21, 19.3%), and ventricular arrhythmia (n = 17, 15.6%). Likelihood of PPM varied with concurrent procedures: left ventricular assist device (3.4%), mitral repair (11.2%), mitral valve replacement (13.7%), aortic and mitral valve replacement (19.2%), and isolated tricuspid repair (6.5%). Older age (odds ratio [OR], 1.020; 95% CI, 1.003-1.036), prior mediastinal radiation (OR, 4.106; 95% CI, 1.598-10.554), and concomitant mitral and aortic valve replacement (OR, 1.963; 95% CI, 1.046-3.683) were risk factors, and concomitant left ventricular assist device implantation (OR, 0.325; 95% CI, 0.139-0.759) was a protective factor for PPM implantation. PPM implantation did not affect the early outcomes, overall survival (P =.287), or cumulative incidence of recurrent moderate or greater tricuspid regurgitation (P =.890) or TV reoperation (P =.602).

Conclusions

The likelihood of PPM implantation after TV repair is relatively high, but PPM implantation does not affect the early and long-term clinical outcomes. Older age, prior mediastinal radiation, and concomitant mitral and aortic valve replacement are risk factors, and concomitant left ventricular assist device implantation is a protective factor for PPM implantation after TV repair.

{"title":"Incidence and Risk Factors for Permanent Pacemaker Implantation After Tricuspid Valve Repair","authors":"Jae Woong Choi MD, PhD , Muath Bishawi MD, PhD , Carmelo Milano MD , Jeffrey Gaca MD , Keith Carr BS , Andrew Wang MD , Donald D. Glower MD","doi":"10.1016/j.atssr.2024.08.003","DOIUrl":"10.1016/j.atssr.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Although the likelihood of needing a permanent pacemaker (PPM) after tricuspid valve (TV) repair has been thought to be low compared with TV replacement, the incidence and determinants are controversial. This study aimed to evaluate the incidence and risk factors for PPM implantation after TV repair.</div></div><div><h3>Methods</h3><div>A total of 1237 consecutive patients undergoing TV repair from 1997 to 2019 were reviewed using a prospectively maintained database, and 1058 patients were enrolled.</div></div><div><h3>Results</h3><div>Incidence of PPM implantation was 10.3% (n = 109). Median time to PPM implantation was 7 (range, 6-9) days. Indications for PPM implantation were heart block (n = 62, 56.9%), junctional or sinus bradycardia (n = 21, 19.3%), and ventricular arrhythmia (n = 17, 15.6%). Likelihood of PPM varied with concurrent procedures: left ventricular assist device (3.4%), mitral repair (11.2%), mitral valve replacement (13.7%), aortic and mitral valve replacement (19.2%), and isolated tricuspid repair (6.5%). Older age (odds ratio [OR], 1.020; 95% CI, 1.003-1.036), prior mediastinal radiation (OR, 4.106; 95% CI, 1.598-10.554), and concomitant mitral and aortic valve replacement (OR, 1.963; 95% CI, 1.046-3.683) were risk factors, and concomitant left ventricular assist device implantation (OR, 0.325; 95% CI, 0.139-0.759) was a protective factor for PPM implantation. PPM implantation did not affect the early outcomes, overall survival (<em>P</em> =.287), or cumulative incidence of recurrent moderate or greater tricuspid regurgitation (<em>P</em> =.890) or TV reoperation (<em>P</em> =.602).</div></div><div><h3>Conclusions</h3><div>The likelihood of PPM implantation after TV repair is relatively high, but PPM implantation does not affect the early and long-term clinical outcomes. Older age, prior mediastinal radiation, and concomitant mitral and aortic valve replacement are risk factors, and concomitant left ventricular assist device implantation is a protective factor for PPM implantation after TV repair.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 37-41"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512413","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

V-Shaped Incision of the Proximal Cartilage for High-Caliber Mismatch in Bronchoplasty 用于支气管成形术中高口径错配的近端软骨 V 形切口

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.04.006

Yukio Watanabe MD , Aritoshi Hattori MD , Mariko Fukui MD , Takeshi Matsunaga MD , Kazuya Takamochi MD , Hisashi Tomita PhD , Kenji Suzuki MD

Background

The problem of high-caliber mismatch in bronchoplasty is not uncommon. This report describes a technique using a V-shaped proximal cartilage incision to adjust high-caliber mismatch.

Methods

Among 255 patients who underwent tracheoplasty or bronchoplasty at a single institution (Juntendo University School of Medicine, Tokyo, Japan) between February 2008 and December 2022, 12 patients (4.7%) who underwent bronchoplasty with a proximal cartilage V-shaped incision for the adjustment of high-caliber mismatch were investigated. Bronchial anastomosis was performed using a continuous running monofilament suture at the bottom of the cartilage. Interrupted 3-0 or 4-0 monofilament sutures were used for the remaining cartilaginous tissue. Before completing the cartilaginous suture, a V-shaped incision was made in the proximal cartilage at the junction of the membranous portion. The cartilage and membranous portion of the incision were sutured using 3 interrupted sutures with 4-0 polydioxanone sutures. Finally, the membranous portion was sutured to complete the anastomosis.

Results

Eleven patients were men, and the median age was 66 years. The histologic diagnoses were adenocarcinoma in 2 patients and squamous cell carcinoma in 10 patients. Three patients underwent operation after definitive chemoradiotherapy. Right sleeve pneumonectomy, right upper sleeve lobectomy, type A extended-sleeve lobectomy, and type C extended-sleeve lobectomy were performed in 7 patients, 3 patients, 1 patient, and 1 patient, respectively. No anastomotic complications were observed. The V-shaped incision group had a significantly higher frequency of right sleeve pneumonectomy than the group without the V-shaped incision (P < .01).

Conclusions

Creation of a proximal cartilaginous V-shaped incision is a useful technique for adjusting high-caliber mismatch, especially in right sleeve pneumonectomy.

{"title":"V-Shaped Incision of the Proximal Cartilage for High-Caliber Mismatch in Bronchoplasty","authors":"Yukio Watanabe MD , Aritoshi Hattori MD , Mariko Fukui MD , Takeshi Matsunaga MD , Kazuya Takamochi MD , Hisashi Tomita PhD , Kenji Suzuki MD","doi":"10.1016/j.atssr.2024.04.006","DOIUrl":"10.1016/j.atssr.2024.04.006","url":null,"abstract":"<div><h3>Background</h3><div>The problem of high-caliber mismatch in bronchoplasty is not uncommon. This report describes a technique using a V-shaped proximal cartilage incision to adjust high-caliber mismatch.</div></div><div><h3>Methods</h3><div>Among 255 patients who underwent tracheoplasty or bronchoplasty at a single institution (Juntendo University School of Medicine, Tokyo, Japan) between February 2008 and December 2022, 12 patients (4.7%) who underwent bronchoplasty with a proximal cartilage V-shaped incision for the adjustment of high-caliber mismatch were investigated. Bronchial anastomosis was performed using a continuous running monofilament suture at the bottom of the cartilage. Interrupted 3-0 or 4-0 monofilament sutures were used for the remaining cartilaginous tissue. Before completing the cartilaginous suture, a V-shaped incision was made in the proximal cartilage at the junction of the membranous portion. The cartilage and membranous portion of the incision were sutured using 3 interrupted sutures with 4-0 polydioxanone sutures. Finally, the membranous portion was sutured to complete the anastomosis.</div></div><div><h3>Results</h3><div>Eleven patients were men, and the median age was 66 years. The histologic diagnoses were adenocarcinoma in 2 patients and squamous cell carcinoma in 10 patients. Three patients underwent operation after definitive chemoradiotherapy. Right sleeve pneumonectomy, right upper sleeve lobectomy, type A extended-sleeve lobectomy, and type C extended-sleeve lobectomy were performed in 7 patients, 3 patients, 1 patient, and 1 patient, respectively. No anastomotic complications were observed. The V-shaped incision group had a significantly higher frequency of right sleeve pneumonectomy than the group without the V-shaped incision (<em>P</em> < .01).</div></div><div><h3>Conclusions</h3><div>Creation of a proximal cartilaginous V-shaped incision is a useful technique for adjusting high-caliber mismatch, especially in right sleeve pneumonectomy.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 128-132"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793507","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

Open-Hybrid Aortic Stent Placement for Recurrent Coarctation in Complex Single Ventricles

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.09.021

Andrew K. Morse BS , Blaz Podgorsek MD , Julija Dobrila MD , Zachary A. Cerra MD , Kiran K. Mallula MD, MS , Muhammad S. Khan MD , Christopher E. Greenleaf MD, MBA , Jorge D. Salazar MD , Damien J. LaPar MD, MSc , Peter C. Chen MD

Recurrent coarctation of the aorta in patients with hypoplastic left heart syndrome requires timely intervention to limit ventricular dysfunction and atrioventricular valve regurgitation. Current strategies include catheter-based intervention in adequately sized patients or surgical arch augmentation at the time of a concomitant operation. We report an open-hybrid surgical technique with placement of a balloon-expandable stent that can later be expanded to an adult size as the patient grows. Limiting the arch dissection reduces the risk to the left recurrent laryngeal nerve and shortens anterograde cerebral perfusion time.

引用次数: 0

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Annals of thoracic surgery short reports

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