Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.09.008
Bo Yang MD, PhD , Kenneth R. Hassler DO , Sarah Chen MD, MS , Marc Titsworth BS , Nicole White MS
Y-incision aortic annular enlargement has been used for 4 years with favorable early outcomes. Occasionally, we have seen a tensed anastomotic suture line of the rectangular patch to the aortomitral curtain/mitral annulus. We developed an Arc modification of the rectangular patch that completely resolved this issue. The Arc modification has been our new routine since May 2024 for Y-incision aortic annular enlargement in all first-time aortic valve replacements or in some reoperative aortic valve replacements if the aortomitral curtain was preserved. The outcomes were favorable, and there were no issues of hemostasis of the suture line.
{"title":"“Arc” Modification of the Patch for the Y-Incision Aortic Annular Enlargement","authors":"Bo Yang MD, PhD , Kenneth R. Hassler DO , Sarah Chen MD, MS , Marc Titsworth BS , Nicole White MS","doi":"10.1016/j.atssr.2024.09.008","DOIUrl":"10.1016/j.atssr.2024.09.008","url":null,"abstract":"<div><div>Y-incision aortic annular enlargement has been used for 4 years with favorable early outcomes. Occasionally, we have seen a tensed anastomotic suture line of the rectangular patch to the aortomitral curtain/mitral annulus. We developed an Arc modification of the rectangular patch that completely resolved this issue. The Arc modification has been our new routine since May 2024 for Y-incision aortic annular enlargement in all first-time aortic valve replacements or in some reoperative aortic valve replacements if the aortomitral curtain was preserved. The outcomes were favorable, and there were no issues of hemostasis of the suture line.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 14-17"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512410","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}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.020
Konmal Ali , Syed Shaheer Ali , Sara Sakowitz MS, MPH , Yas Sanaiha MD , Saad Mallick MD , Peyman Benharash MD
Background
Although an integral component of cardiac valve operations, manual knot tying has been linked with increased operative times and greater costs. The introduction of the Cor-Knot device (LSI Solutions) has eliminated hand-tied knots through an automatic titanium fastener system. However, adverse outcomes related to this device remain unknown. We thus used a nationally representative cohort to characterize adverse events of the Cor-Knot.
Methods
All adverse events for the Cor-Knot from 2015-2023 were tabulated from the Manufacturer and User Facility Device Experience database. Reports were screened to assess incident type and complication. Device and patient complications were categorized and reported as proportions to further ascertain factors contributing to the development of adverse incidents.
Results
Of an estimated 74 adverse events, the number of reported occurrences increased over the study period from 1 in 2015 to 13 in 2023. The greatest proportion of adverse events involved the Cor-Knot Mini (41.9%) or the Cor-Knot (37.4%), with malfunction representing the most frequent device incident (63.5%). Problems related to device usage (22.8%) or misfire (22.8%) constituted the most frequent complications after Cor-Knot usage. The most frequent complications included valve insufficiency (10.8%), presence of a foreign body (8.1%), or hemorrhage (2.7%).
Conclusions
Of all reported adverse events, malfunction was most likely to occur due to misfire or device usage issues. Patient complications comprised valve insufficiency, foreign body presence, or hemorrhage. As adoption and utilization of the Cor-Knot increases, future work is necessary to ensure adequate device training and minimize the incidence of adverse events.
{"title":"Acute Clinical Adverse Outcomes Associated With the Cor-Knot","authors":"Konmal Ali , Syed Shaheer Ali , Sara Sakowitz MS, MPH , Yas Sanaiha MD , Saad Mallick MD , Peyman Benharash MD","doi":"10.1016/j.atssr.2024.07.020","DOIUrl":"10.1016/j.atssr.2024.07.020","url":null,"abstract":"<div><h3>Background</h3><div>Although an integral component of cardiac valve operations, manual knot tying has been linked with increased operative times and greater costs. The introduction of the Cor-Knot device (LSI Solutions) has eliminated hand-tied knots through an automatic titanium fastener system. However, adverse outcomes related to this device remain unknown. We thus used a nationally representative cohort to characterize adverse events of the Cor-Knot.</div></div><div><h3>Methods</h3><div>All adverse events for the Cor-Knot from 2015-2023 were tabulated from the Manufacturer and User Facility Device Experience database. Reports were screened to assess incident type and complication. Device and patient complications were categorized and reported as proportions to further ascertain factors contributing to the development of adverse incidents.</div></div><div><h3>Results</h3><div>Of an estimated 74 adverse events, the number of reported occurrences increased over the study period from 1 in 2015 to 13 in 2023. The greatest proportion of adverse events involved the Cor-Knot Mini (41.9%) or the Cor-Knot (37.4%), with malfunction representing the most frequent device incident (63.5%). Problems related to device usage (22.8%) or misfire (22.8%) constituted the most frequent complications after Cor-Knot usage. The most frequent complications included valve insufficiency (10.8%), presence of a foreign body (8.1%), or hemorrhage (2.7%).</div></div><div><h3>Conclusions</h3><div>Of all reported adverse events, malfunction was most likely to occur due to misfire or device usage issues. Patient complications comprised valve insufficiency, foreign body presence, or hemorrhage. As adoption and utilization of the Cor-Knot increases, future work is necessary to ensure adequate device training and minimize the incidence of adverse events.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 31-36"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512412","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}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.09.010
Jessica M. Ruck MD, PhD , Camille Hage MD, MPH , Tao Liang MSPH , Darren E. Stewart MS , Jinny S. Ha MD, MHS , Allan B. Massie PhD , Dorry L. Segev MD, PhD , Christian A. Merlo MD, MPH , Errol L. Bush MD
Background
Preoperative opioid use (OU) is a strong risk factor for poor postoperative outcomes in other surgical populations but has not been explored in lung transplant (LT) recipients nationally.
Methods
The study identified adult (aged ≥18 years) US lung transplant (LT) recipients from 2011 to 2021 in the Scientific Registry of Transplant Recipients with prescription data through a pharmacy data set. Posttransplantation ventilatory support, infection, and mortality by pretransplantation OU (prescription fill ≤6 months before transplantation) were compared using multivariable regression.
Results
Among 17,285 LT recipients, 17.9% had pretransplantation OU. The odds of posttransplantation opioid prescription fill were 3.18-fold higher 0 to 6 months after transplantation (adjusted odds ratio [aOR], 3.18; 95% CI, 2.91-3.47; P < .001) and 14.29-fold higher 6 to 12 months after transplantation (aOR, 14.29; 95% CI, 12.61-16.19; P < .001) among LT recipients with vs without pretransplantation OU. Pretransplantation OU was associated with 16% higher posttransplantation mortality (adjusted hazard ratio, 1.16; 95% CI, 1.09-1.25; P < .001) and a higher risk of ventilator use >48 hours (aOR, 1.14; 95% CI, 1.04-1.25; P = .006).
Conclusions
Pretransplantation OU was the strongest independent risk factor for posttransplantation OU and was associated with greater morbidity and mortality. Reducing pretransplantation and posttransplantation OU could benefit LT recipients and should be explored.
{"title":"Association of Pre–Lung Transplant Opioid Use With Posttransplant Opioid Use and Outcomes","authors":"Jessica M. Ruck MD, PhD , Camille Hage MD, MPH , Tao Liang MSPH , Darren E. Stewart MS , Jinny S. Ha MD, MHS , Allan B. Massie PhD , Dorry L. Segev MD, PhD , Christian A. Merlo MD, MPH , Errol L. Bush MD","doi":"10.1016/j.atssr.2024.09.010","DOIUrl":"10.1016/j.atssr.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative opioid use (OU) is a strong risk factor for poor postoperative outcomes in other surgical populations but has not been explored in lung transplant (LT) recipients nationally.</div></div><div><h3>Methods</h3><div>The study identified adult (aged ≥18 years) US lung transplant (LT) recipients from 2011 to 2021 in the Scientific Registry of Transplant Recipients with prescription data through a pharmacy data set. Posttransplantation ventilatory support, infection, and mortality by pretransplantation OU (prescription fill ≤6 months before transplantation) were compared using multivariable regression.</div></div><div><h3>Results</h3><div>Among 17,285 LT recipients, 17.9% had pretransplantation OU. The odds of posttransplantation opioid prescription fill were 3.18-fold higher 0 to 6 months after transplantation (adjusted odds ratio [aOR], 3.18; 95% CI, 2.91-3.47; <em>P</em> < .001) and 14.29-fold higher 6 to 12 months after transplantation (aOR, 14.29; 95% CI, 12.61-16.19; <em>P</em> < .001) among LT recipients with vs without pretransplantation OU. Pretransplantation OU was associated with 16% higher posttransplantation mortality (adjusted hazard ratio, 1.16; 95% CI, 1.09-1.25; <em>P</em> < .001) and a higher risk of ventilator use >48 hours (aOR, 1.14; 95% CI, 1.04-1.25; <em>P</em> = .006).</div></div><div><h3>Conclusions</h3><div>Pretransplantation OU was the strongest independent risk factor for posttransplantation OU and was associated with greater morbidity and mortality. Reducing pretransplantation and posttransplantation OU could benefit LT recipients and should be explored.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 235-240"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512418","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}
When tumor is located in the superior segment of the lower lobe (S6) close to the intersegmental plane with the posterior basal segment (S10), bisegmentectomy of S6 and S10 is oncologically feasible and reasonable to preserve lung parenchyma. However, this bisegmentectomy is technically challenging because of the complex anatomy of S10. Herein, we report a successful case of left S6+S10 segmentectomy by a robotic approach with sufficient surgical margin. A robotic approach is suitable for such a complex segmentectomy of the lower lobe because of the good looking-up high-definition 3-dimensional view.
{"title":"Robotic Left Superior and Posterior Basal (S6+S10) Segmentectomy","authors":"Hitoshi Igai MD, PhD , Akinobu Ida MD , Kazuki Numajiri MD , Kazuhito Nii MD, PhD , Mitsuhiro Kamiyoshihara MD, PhD","doi":"10.1016/j.atssr.2024.07.028","DOIUrl":"10.1016/j.atssr.2024.07.028","url":null,"abstract":"<div><div>When tumor is located in the superior segment of the lower lobe (S6) close to the intersegmental plane with the posterior basal segment (S10), bisegmentectomy of S6 and S10 is oncologically feasible and reasonable to preserve lung parenchyma. However, this bisegmentectomy is technically challenging because of the complex anatomy of S10. Herein, we report a successful case of left S6+S10 segmentectomy by a robotic approach with sufficient surgical margin. A robotic approach is suitable for such a complex segmentectomy of the lower lobe because of the good looking-up high-definition 3-dimensional view.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 186-189"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512548","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}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.016
Jennifer M. Nishimura MD , Camille Yongue MD , Fang Zhou MD , Stephanie H. Chang MD, MSCI
Cystic degeneration of thymoma can occur, although rarely to the extent that the lesion appears entirely cystic. We present a case of a 26-year-old man with a large anterior mediastinal cyst that was resected with histopathologic examination revealing a cystic thymoma.
{"title":"Cystic Thymoma Masquerading as Simple Pericardial Cyst","authors":"Jennifer M. Nishimura MD , Camille Yongue MD , Fang Zhou MD , Stephanie H. Chang MD, MSCI","doi":"10.1016/j.atssr.2024.07.016","DOIUrl":"10.1016/j.atssr.2024.07.016","url":null,"abstract":"<div><div>Cystic degeneration of thymoma can occur, although rarely to the extent that the lesion appears entirely cystic. We present a case of a 26-year-old man with a large anterior mediastinal cyst that was resected with histopathologic examination revealing a cystic thymoma.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 212-215"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512554","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}
Pulmonary segmentectomy is an established surgical procedure for early-stage lung cancer and metastatic tumors. However, performing complex segmentectomies is challenging owing to the deep intraparenchymal localization of hilar structures and anatomic variations. Moreover, particular attention should be paid to avoid intraoperative bronchial misidentification. The surgeon can consider enhancing the precision of segmentectomy by marking the segmental bronchus preoperatively. Herein, we report a simple technique that employs indocyanine green to identify the segmental bronchus during pulmonary segmentectomy.
{"title":"Identification of the Segmental Bronchus Using Indocyanine Green During Thoracoscopic Segmentectomy","authors":"Satoshi Takamori PhD , Ayako Niwa MD , Marina Nakatsuka MD , Makoto Endo PhD","doi":"10.1016/j.atssr.2024.08.007","DOIUrl":"10.1016/j.atssr.2024.08.007","url":null,"abstract":"<div><div>Pulmonary segmentectomy is an established surgical procedure for early-stage lung cancer and metastatic tumors. However, performing complex segmentectomies is challenging owing to the deep intraparenchymal localization of hilar structures and anatomic variations. Moreover, particular attention should be paid to avoid intraoperative bronchial misidentification. The surgeon can consider enhancing the precision of segmentectomy by marking the segmental bronchus preoperatively. Herein, we report a simple technique that employs indocyanine green to identify the segmental bronchus during pulmonary segmentectomy.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 183-185"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512426","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}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.026
Alfonso Fiorelli MD, PhD , Anna Cecilia Izzo MD , Vincenzo Di Filippo MD , Francesca Capasso MD , Domenico Galetta MD , Giovanni Natale MD
A high-output chyle leak developed in a 69-year-old man who had undergone pleurectomy and decortication for malignant pleural mesothelioma. Conservative treatment was unsuccessful while a clear area of leakage could not be identified on lymphangiography. Right-sided robotic reexploration with ligation of the thoracic duct was successfully performed. The patient was discharged 6 days later, and no recurrence was observed.
{"title":"Robotic Treatment of Postoperative Chylothorax","authors":"Alfonso Fiorelli MD, PhD , Anna Cecilia Izzo MD , Vincenzo Di Filippo MD , Francesca Capasso MD , Domenico Galetta MD , Giovanni Natale MD","doi":"10.1016/j.atssr.2024.07.026","DOIUrl":"10.1016/j.atssr.2024.07.026","url":null,"abstract":"<div><div>A high-output chyle leak developed in a 69-year-old man who had undergone pleurectomy and decortication for malignant pleural mesothelioma. Conservative treatment was unsuccessful while a clear area of leakage could not be identified on lymphangiography. Right-sided robotic reexploration with ligation of the thoracic duct was successfully performed. The patient was discharged 6 days later, and no recurrence was observed.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 222-224"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512552","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}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.003
Zaid Abood MD , M. Fuad Jan MBBS (Hons), MD , Omar Nahhas MD , Suhail Q. Allaqaband MD , Tanvir Bajwa MD , Eric S. Weiss MD, MPH
A 60-year-old man with diabetes mellitus and aortic stenosis who had undergone transcatheter aortic valve replacement (TAVR) presented with persistent TAVR-associated infective endocarditis (TAVR IE) despite a prolonged antibiotic course. TAVR IE is a rare yet fatal complication, with surgical treatment carrying a high mortality rate, particularly in patients with systolic heart dysfunction. We present a case of successful TAVR explantation with left ventricular assist device insertion in a patient with persistent TAVR IE and refractory congestive heart failure with a left ventricular ejection fraction of 20%.
{"title":"Concurrent Explant of Infected Transcatheter Aortic Valve and Implant of Ventricular Assist Device","authors":"Zaid Abood MD , M. Fuad Jan MBBS (Hons), MD , Omar Nahhas MD , Suhail Q. Allaqaband MD , Tanvir Bajwa MD , Eric S. Weiss MD, MPH","doi":"10.1016/j.atssr.2024.07.003","DOIUrl":"10.1016/j.atssr.2024.07.003","url":null,"abstract":"<div><div>A 60-year-old man with diabetes mellitus and aortic stenosis who had undergone transcatheter aortic valve replacement (TAVR) presented with persistent TAVR-associated infective endocarditis (TAVR IE) despite a prolonged antibiotic course. TAVR IE is a rare yet fatal complication, with surgical treatment carrying a high mortality rate, particularly in patients with systolic heart dysfunction. We present a case of successful TAVR explantation with left ventricular assist device insertion in a patient with persistent TAVR IE and refractory congestive heart failure with a left ventricular ejection fraction of 20%.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 64-66"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840006","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}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.009
Peyton Mashni BS , Clare Savage MD , Michael Jax BS , Anna Maria Reiter BS , Gordon Butler MD , Joseph B. Zwischenberger MD
Background
Accidental catheter removal or drain dislodgment, including tube thoracostomy, is a common, high-risk complication in hospitalized and ambulatory patients that often necessitates an additional procedure, increased length of stay, and increased cost.
Methods
The aim of this study was to compare the tensile strength of pigtail catheter fixation using a simple interrupted suture, a U-stitch suture, or 2 simple interrupted skin sutures in a standardized skin model. Catheters were sutured to the skin, penetrating the collagen layer, with 1 of the 3 suture techniques and varying suture combinations.
Results
For each trial, breakage occurred at the suture or knot. The mean breakpoint varied significantly between 2 simple interrupted sutures and both the 1 simple interrupted suture and the U-stitch technique (analysis of variance post hoc test P < .001), with the 2 simple interrupted suture technique withholding nearly 40% more force. Using the strongest suture, 0 silk, on a deceased adult sheep to secure a pigtail thoracostomy catheter yielded identical data compared with the standardized skin model.
Conclusions
In conclusion, 2 simple interrupted skin sutures to secure a pigtail catheter has very low risk with a strongly positive benefit.
{"title":"The Catheter Fell Out","authors":"Peyton Mashni BS , Clare Savage MD , Michael Jax BS , Anna Maria Reiter BS , Gordon Butler MD , Joseph B. Zwischenberger MD","doi":"10.1016/j.atssr.2024.07.009","DOIUrl":"10.1016/j.atssr.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Accidental catheter removal or drain dislodgment, including tube thoracostomy, is a common, high-risk complication in hospitalized and ambulatory patients that often necessitates an additional procedure, increased length of stay, and increased cost.</div></div><div><h3>Methods</h3><div>The aim of this study was to compare the tensile strength of pigtail catheter fixation using a simple interrupted suture, a U-stitch suture, or 2 simple interrupted skin sutures in a standardized skin model. Catheters were sutured to the skin, penetrating the collagen layer, with 1 of the 3 suture techniques and varying suture combinations.</div></div><div><h3>Results</h3><div>For each trial, breakage occurred at the suture or knot. The mean breakpoint varied significantly between 2 simple interrupted sutures and both the 1 simple interrupted suture and the U-stitch technique (analysis of variance post hoc test <em>P</em> < .001), with the 2 simple interrupted suture technique withholding nearly 40% more force. Using the strongest suture, 0 silk, on a deceased adult sheep to secure a pigtail thoracostomy catheter yielded identical data compared with the standardized skin model.</div></div><div><h3>Conclusions</h3><div>In conclusion, 2 simple interrupted skin sutures to secure a pigtail catheter has very low risk with a strongly positive benefit.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 281-285"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844300","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}
We report a case in which a migrated fractured sternal wire fragment was successfully retrieved using interventional radiology. After a median sternotomy for coronary artery bypass grafting, a migrated fracture wire initially strayed into the right ventricular myocardium, then migrated into the right pulmonary artery, and subsequently into the left pulmonary artery, 34 months after coronary artery bypass grafting. Computed tomography and angiography revealed that the wire was located in the peripheral left lower lobe branch of the A8 pulmonary artery. It was retrieved from the A8 left pulmonary artery using a gooseneck snare under X-ray fluoroscopy.
{"title":"Successful Interventional Removal of a Migrated Sternal Wire in the Pulmonary Artery","authors":"Daikichi Meguro MD , Toshihiro Osaki MD, PhD , Soichi Oka MD, PhD , Hiroyuki Ueda MD, PhD , Tatsuji Okada MD , Nobuhisa Ono MD, PhD","doi":"10.1016/j.atssr.2024.09.013","DOIUrl":"10.1016/j.atssr.2024.09.013","url":null,"abstract":"<div><div>We report a case in which a migrated fractured sternal wire fragment was successfully retrieved using interventional radiology. After a median sternotomy for coronary artery bypass grafting, a migrated fracture wire initially strayed into the right ventricular myocardium, then migrated into the right pulmonary artery, and subsequently into the left pulmonary artery, 34 months after coronary artery bypass grafting. Computed tomography and angiography revealed that the wire was located in the peripheral left lower lobe branch of the A8 pulmonary artery. It was retrieved from the A8 left pulmonary artery using a gooseneck snare under X-ray fluoroscopy.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 164-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511695","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}
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