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The median survival after lung retransplantation (ReLTx) reported to the ISHLT are restricted to 2.5 years. We report the results after ReLTx from our center.
We report the case of a 56 year-old female with a six-year history of severe epigastric pain following chest compressions for cardiac arrest. A comprehensive gastrointestinal workup was negative. However, an abdominal CT scan demonstrated an elongated xiphoid process. After a xiphoid trigger point injection, she experienced pain relief lasting four days, and thus her symptoms were attributed to xiphoidalgia secondary to heterotopic ossification following trauma. We performed an open resection of the xiphoid...
In patients with critical tracheal stenosis, ECMO support provides an additional level of safety over conventional approaches to secure an airway. This brings operations with exquisite complexity into the realm of routine feasibility. Here we describe a case of combined tracheal resection with four vessel coronary artery bypass grafting in a patient with critical tracheal stenosis, occluded coronary arteries and severely reduced ejection fraction. Post-operatively, the patient made an excellent recovery. Th...
Adenocarcinoma of the gastroesophageal junction (AEG) poses a management challenge, as preoperative prediction of occult mediastinal nodal metastasis is difficult. We sought to identify factors predictive of mediastinal involvement among patients undergoing trimodality therapy.
Perforation of esophageal cancer solely due to preoperative chemotherapy is extremely rare, but can be associated with pyothorax, and be difficult to treat. Here, we first report the case of successfully-treated patient with thoracic esophageal cancer who developed esophageal perforation during DCF (docetaxel, cisplatin, 5-FU) chemotherapy. A 73-year-old patient developed esophageal perforation on the fourth day of the first DCF cycle. The second cycle of DCF was administered after insertion of esophageal s...
Anomalous aortic origin of the left main coronary artery arising from the right coronary sinus with a trans-septal course are rare and pose surgical challenges not addressed by current techniques. Coronary artery bypass grafting though a plausible solution, has an unacceptably high incidence of graft failure due to competitive flow. We describe a novel trans-conal approach to effectively unroof trans-septal left main coronary artery.
Conduit survival without significant dysfunction is important when selecting the right ventricular outflow tract conduit. We made an expanded polytetrafluoroethylene tricuspid valved conduit using a simplified technique. We aimed to investigate the midterm functional results and longevity of this conduit.
The purpose of this study is to assess risk factors of the neo-aortic regurgitation (AR) after arterial switch operation and outcomes of the neo-aortic valve surgery.
The optimal approach to clinical T2N0 (cT2N0) esophageal cancer is unclear. Our objective is to perform a systematic review investigating whether neo-adjuvant therapy results in better outcomes compared to upfront surgery in cT2N0 esophageal cancer.
Paragangliomas are rare neuroendocrine tumors derived from extra-adrenal autonomic paraganglia, which may secrete catecholamines. They are potentially metastatic, and require very long-term follow-up. Esophageal paragangliomas are extremely rare and present a diagnostic challenge. Lack of clinical suspicion and unrecognized catecholamine hypersecretion may lead to hemodynamic instabilities during surgery. Previously, two cases of esophageal paragangliomas were reported. We report the first case of a 39-year...
2018 is the centennial of the naming of heparin by Emmett Holt and William Howell and the 102 anniversary of Jay McLean's discovery of an anticoagulant heparphosphatide at Johns Hopkins. We discuss recently discovered historical artifacts that shed new light on heparin's christening, including McLean's unpublished letter written in 1950 that represents one of the most complete accounts of heparin's discovery prior to his untimely death. We also located a plaque dedicated to McLean and explored the circumsta...
Surgical treatment of constrictive pericarditis (CP) is particularly challenging due to the increased risk of right heart failure. The necessity of postoperative extracorporeal life support (ECLS) can result in mortality rates of 100%. Preemptive implantation of ECLS may improve postoperative outcomes; however, no data are currently available on its use. We conducted a retrospective study in order to evaluate the feasibility of our strategy.
Inappropriate sinus tachycardia (IST) is a rare clinical disorder characterized by an elevated resting heart rate and an exaggerated rate response to exercise or autonomic stress. Pharmacological therapy and catheter ablation are considered first-line treatments for IST but can yield sub-optimal relief of symptoms. The results of surgical ablation at our center were reviewed for patients with refractory IST.
Several options exist for aortic valve replacement (AVR) in children and teens, but contemporary practice pattern and outcome data are lacking. We describe national AVR practice patterns and early outcomes.
Pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) is technically demanding. We tried to identify the predictors for short- and long-term outcomes after PEA for CTEPH with aggressive use of pulmonary vasodilators, including epoprostenol sodium.
The outcomes of surgical treatment of ventricular septal rupture complicating acute myocardial infarction are worse in patients with cardiogenic shock.This study aimed to identify clinical characteristics and outcomes in patients with ventricular septal rupture presenting with cardiogenic shock.
To treat chronic heart failure (CHF), we developed a robust, easy to handle bio absorbable tissue-engineered patch embedded with human neonatal fibroblasts and human induced pluripotent stem cell derived cardiomyocytes (hiPSC-CMs). This patch was implanted on the epicardial surface of the heart covering the previously infarcted tissue.
Detection of small pulmonary lesions has increased and often they are difficult to localize and resect. We present our mature experience with preoperative computer-tomography (CT)-guided radiotracer localization followed by resection of these lesions.