Quality of life outcomes in tracheobronchomalacia surgery.

Tracheobronchomalacia (TBM) is an obstructive airway disease characterized by laxity and redundancy of the posterior membrane of the main airways leading to dynamic airway collapse during exhalation. The gold standard for diagnosis is dynamic computed tomography (DCT) scan and dynamic flexible bronchoscopy (DFB). Patients with complete or near-complete collapse (>90% reduction in cross-sectional area) of the airway are possible candidates for surgical management.

Anti-interferon-α receptor 1 antibodies attenuate inflammation and organ injury following hemorrhagic shock.

Background: Hemorrhagic shock (HS) is a life-threatening condition resulting from rapid and significant loss of intravascular volume, leading to hemodynamic instability and death. Inflammation contributes to the multiple organ injury in HS. Type I interferons (IFNs), such as IFN-α and IFN-β, are a family of cytokines that regulate the inflammatory response through binding to IFN-α receptor (IFNAR) which consists of IFNAR1 and IFNAR2 chains.

Minimally Invasive coronary surgery compared to STernotomy coronary artery bypass grafting: The MIST trial.

Rationale: Minimally invasive cardiac surgery has emerged as a safe alternative to standard cardiac surgery. Minimally invasive coronary surgery (MICS CABG) was developed to allow adequate exposure and complete revascularization in CABG from a small thoracotomy incision without cardiopulmonary bypass. Multiple studies have reported significant shorter length of hospital stay and earlier postoperative physical recovery for MICS CABG patients when compared to sternotomy CABG patients.

Cold-inducible RNA-binding protein-derived peptide C23 attenuates inflammation and tissue injury in a murine model of intestinal ischemia-reperfusion.

Background: Cold-inducible RNA-binding protein is a novel damage-associated molecular pattern that causes inflammation. C23, a short peptide derived from cold-inducible RNA-binding protein, has been found to have efficacy in blocking cold-inducible RNA-binding protein's activity. We hypothesized that C23 reduces inflammation and tissue injury induced by intestinal ischemia-reperfusion.

Improving the Power of the American Society of Anesthesiology Classification System to Risk Stratify Vascular Surgery Patients Based on National Surgical Quality Improvement Project-Defined Functional Status.

Background: Recently published reports have shown that the American Society of Anesthesiology (ASA) classification system has limited applicability in vascular surgery patients. Most patients undergoing vascular procedures are designated as ASA class III, limiting discrimination in preoperative risk assessment. The 2006 National Surgical Quality Improvement Project (NSQIP), containing over 170,000 surgical cases, demonstrated that functional status is an important predictor of mortality.

Evolution of Minimally Invasive Coronary Artery Bypass Grafting: Learning Curve.

Objective: Minimally invasive coronary surgery approach for coronary artery bypass grafting is a safe and reproducible procedure for multivessel revascularization. This study reviewed a single surgeon's experience with minimally invasive coronary surgery coronary artery bypass grafting, including operative time, number of bypasses, and conversion to sternotomy.

Methods: A prospective database of consecutive minimally invasive coronary surgery coronary artery bypass grafting procedures from 2005 to 2013 was reviewed.

The Protective Effect of A Short Peptide Derived From Cold-Inducible RNA-Binding Protein in Renal Ischemia-Reperfusion Injury.

Extracellular cold-inducible RNA-binding protein (CIRP) functions as damage-associated molecular pattern and has been demonstrated to be responsible in part for the damage occurring after renal ischemia-reperfusion (I/R). A short peptide derived from CIRP, named C23, binds to myeloid differentiation factor 2, a Toll-like receptor 4 coreceptor. We hypothesize that C23 reduces renal ischemia-reperfusion (RIR) injury by blocking CIRP.

Deficiency in cold-inducible RNA-binding protein attenuates acute respiratory distress syndrome induced by intestinal ischemia-reperfusion.

Background: Intestinal ischemia-reperfusion can occur in shock and mesenteric occlusive diseases, causing significant morbidity and mortality. Aside from local injury, intestinal ischemia-reperfusion can result in remote organ damage, particularly in the lungs. Cold-inducible RNA-binding protein (CIRP) was identified as a novel inflammatory mediator.

Cost Analysis of Physician Assistant Home Visit Program to Reduce Readmissions After Cardiac Surgery.

Background: A physician assistant home care (PAHC) program providing house calls was initiated to reduce hospital readmissions after adult cardiac surgery. The purpose of our study was to compare 30-day PAHC and pre-PAHC readmission rate, length of stay, and cost.

Methods: Patients who underwent adult cardiac surgery in the 48 months from September 2008 through August 2012 were retrospectively reviewed using pre-PAHC patients as the control group.

Long-term Outcome after Percutaneous Coronary Intervention Compared with Minimally Invasive Coronary Artery Bypass Surgery in the Elderly.

Background: Elderly patients with unstable coronary artery disease (CAD) have better outcomes with coronary revascularization than conservative treatment. With the improvement in percutaneous coronary intervention (PCI) techniques using drug eluting-stents, this became an attractive option in elderly. Minimally invasive coronary artery bypass grafting (MICS-CABG) is a safe and effective alternative to conventional CABG.

Identification of Risk Factors for Cervical Spine Injury from Pediatric Trauma Registry.

Background: Cervical spine injuries are rare in children. Our goal is to establish guidelines for cervical spine clearance that are practical for our pediatric population, and, in the process, to reduce the risk of radiation exposure from unnecessary advanced imaging.

Methods: We retrospectively reviewed the records from the registries of two pediatric trauma centers from the past 11 years (January 2002 to June 2013).

Minimally Invasive Valve Surgery and Single Vessel Coronary Artery Bypass via Limited Anterior Right Thoracotomy.

Background: Coronary artery bypass grafting with aortic valve replacement (AVR) or mitral valve replacement (MVR) is traditionally performed via sternotomy. Minimally invasive coronary surgery (MICS) and minimally invasive valve surgery have been successfully performed independently. Patients with critical right coronary artery (RCA) stenosis not amenable to percutaneous intervention are candidates for valve replacement and single vessel coronary artery bypass.

Hyperplastic cardiac sarcoma recurrence.

Primary cardiac sarcomas are rare tumors with a median survival of 6-12 months. Data suggest that an aggressive multidisciplinary approach may improve patient outcome. We present the case of a male who underwent resection of cardiac sarcoma three times from the age of 32 to 34.

Twenty-four hour staged carotid endarterectomy followed by off-pump coronary bypass grafting for patients with concomitant carotid and coronary disease.

Background: Carotid artery stenosis and coronary artery disease share common risk factors and often coexist in the same patient. Currently, no consensus exists regarding the optimal treatment strategy for patients with concomitant severe coronary and carotid disease. We reviewed the results of our experience performing off-pump coronary artery bypass grafting (CABG) within 24 hours of carotid endarterectomy (CEA) in this select patient population.

Long-term mortality in minimally invasive compared with sternotomy coronary artery bypass surgery in the geriatric population (75 years and older patients).

Objectives: Ischaemic heart disease is the leading cause of death in the elderly population. Coronary artery bypass graft (CABG) surgery via sternotomy remains the standard of care for patients with multivessel coronary artery disease (CAD). Minimally invasive cardiac surgery (MICS)-CABG via left thoracotomy has been used as an alternative to sternotomy.

Results of the Minimally Invasive Coronary Artery Bypass Grafting Angiographic Patency Study.

Objective: Minimally invasive coronary artery bypass grafting is safe and widely applicable, and may be associated with fewer transfusions and infections, and better recovery than standard coronary artery bypass grafting. However, graft patency rates remain unknown. The Minimally Invasive Coronary Artery Bypass Grafting Patency Study prospectively evaluated angiographic graft patency 6 months after minimally invasive coronary artery bypass grafting.

Minimally invasive coronary artery bypass grafting: is it time for the robot?

Purpose Of Review: Minimally invasive coronary artery bypass grafting (MICS CABG) consists of single-vessel or multivessel revascularization via a small left thoracotomy, and has been proposed as an alternative to a standard sternotomy approach. The purpose of this article is to examine the current status of MICS CABG and discuss its future directions.

Recent Findings: Experience in the first 450 cases was reported in 2009, and established the efficacy and safety of a small thoracotomy approach for multivessel and single-vessel revascularization.

Elevated preoperative neutrophil/lymphocyte ratio as a predictor of increased long-term survival in minimal invasive coronary artery bypass surgery compared to sternotomy.

Background: Neutrophil lymphocyte ratio (NLR) is a predictor of major adverse cardiovascular outcomes. Our study explores the value of NLR in predicting long-term mortality after minimally invasive coronary artery bypass surgery (MICS) via lateral left-thoracotomy versus conventional sternotomy coronary artery bypass grafting (CABG) surgery.

Methods: A total of 1126 consecutive patients (729 sternotomy CABG and 397 MICS) from a single tertiary center between 2005 and 2008 were followed until 2011.

Experience with a minimally invasive approach to combined valve surgery and coronary artery bypass grafting through bilateral thoracotomies.

Background: Minimally invasive coronary artery bypass grafting (MICS-CABG) and minimally invasive valve surgery (MIVS) have been used independently to manage occlusive coronary artery disease and valvular diseases, respectively. We present 12 patients who underwent combined MICS-CABG and MIVS via bilateral mini-thoracotomies.

Methods: We retrospectively reviewed 116 consecutive valve/CABG operations by a single surgeon and compared the outcomes obtained via sternotomy with those obtained via bilateral minithoracotomies.

CASE REPORT Anomalies Associated With Congenitally Corrected Transposition of Great Arteries: Expect the Unexpected.

Objective: Congenitally corrected transposition of great arteries (CCTGA) is characterized by atrioventricular and ventriculoarterial discordance. Characterizations of these anomalies are important because they may influence surgical approach and management.

Methods: We present a case of newly diagnosed CCTGA at the age of 50.

CASE REPORT Sternal Chondrosarcoma After Sternotomy for Coronary Artery Bypass Grafting.

Objective: Primary bony tumors of the chest wall are usually benign and most commonly located in the ribs or sternum. Chondrosarcoma is regarded as one of the most frequent primary malignancies of the chest wall and its incidence after a sternotomy for a cardiac procedure is extremely rare. We present a case of sternal chondrosarcoma.

Physician assistant home visit program to reduce hospital readmissions.

Objective: A physician assistant home care (PAHC) program providing house calls was initiated to decrease hospital readmission rates. We evaluated the 30-day readmission rates and diagnoses before and during PAHC to identify determinants of readmission and interventions to reduce readmissions.

Methods: Patients who underwent cardiac surgery were evaluated postoperatively for 13 months as pre-PAHC (control group) and 13 months with PAHC.

Neutrophil-lymphocyte ratio as a predictor of major adverse cardiac events among diabetic population: a 4-year follow-up study.

The neutrophil-lymphocyte ratio (NLR) is an inflammatory marker of major adverse cardiac events (MACEs) in both acute coronary syndromes and stable coronary artery disease. The use of NLR as a predictive tool for MACEs among diabetic patients has not been elucidated. An observational study included 338 diabetic patients followed at our clinic between 2007 and 2011.