Pre-existing pulmonary fibrosis is associated with adverse outcomes after lung resection.

Introduction: Pulmonary fibrosis is a risk factor for the development of lung cancer. However, the low incidence of the pathology means that it is not well represented in thoracic surgery risk scoring systems. We aimed to assess whether short and long-term outcomes after lung resection for primary lung cancer were worse in patients with pre-existing pulmonary fibrosis.

Is open window thoracostomy the only method to control infection in patients with an empyema following pulmonary resection for primary lung cancer?

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed: Is open window thoracostomy (OWT) the only method to control infection in patients with an empyema following pulmonary resection for primary lung cancer? Altogether 442 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Spontaneousrupture of a giant thoracic duct cyst presenting with abdominal pain and a tension chylothorax.

Ruptured thoracic duct cysts are an extremely rare occurrence that may arise spontaneously or due to trauma. Surgical treatment is needed to provide a definitive diagnosis, drain the chylothorax and ligate the thoracic duct to prevent reoccurrence. We report the case of a woman with a ruptured thoracic duct cyst presenting with abdominal pain and subsequent tension chylothorax.

Mitral valve repair or replacement in native valve endocarditis? Systematic review and meta-analysis.

Objective: The objective of this study is to review the morbidity and mortality associated with mitral valve repair versus replacement in infective endocarditis patients.

Methods: A comprehensive search was undertaken among the four major databases (PubMed, Embase, Scopus, and Ovid) to identify all available data comparing mitral valve repair or replacement in infective endocarditis. Databases were evaluated and assessed to March 2017.

Hormonal manipulation after surgery for catamenial pneumothorax.

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether hormonal manipulation with gonadotrophin-releasing hormone analogues reduces the risk of recurrent catamenial pneumothorax after surgery, compared with surgery alone. Altogether 819 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question.

A systematic review and meta-analysis of mechanical vs biological composite aortic root replacement, early and 1-year results.

Objective: Composite aortic root replacement is a standard procedure for various aortic root pathologies. This systematic review was set to identify the postoperative outcomes for composite mechanical root replacement (mCRR) compared to composite biological root replacement (bCRR).

Methods: We systematically reviewed four major databases for all papers assessing outcomes in composite root replacement.

Fistula of right internal thoracic artery as a rare cause of chest pain.

Variation in the origin of the internal thoracic arteries has been previously described and reported in the literature; however, there has been no report of an anomalous termination of the right internal thoracic artery into the pulmonary vein persisting and presenting in adult life. We report the case of the right internal thoracic artery originating from the first part of subclavian artery but terminating into the right superior pulmonary vein that presented during the third decade of life.

Anomalous Right Internal Thoracic Artery Terminating in the Right Superior Pulmonary Vein.

Variation in the origin of the internal thoracic arteries has been previously described and reported in the literature; however, there has been no report of an anomalous termination of the right internal thoracic artery (RITA) in the pulmonary vein persisting and presenting in adult life. We report the case of a right internal thoracic artery originating from the first part of the subclavian artery but terminating in the right superior pulmonary vein that presented during the third decade of life.

Missed aortic valve endocarditis resulting in complete atrioventricular block and redo mechanical valve replacement.

Infective endocarditis is a rare disease associated with high morbidity and mortality. As a result, early diagnosis and prompt antibiotic treatment with or without surgical intervention is crucial in the management of such condition.We report a case of missed infective endocarditis of the aortic valve.

Anomalous origin of the circumflex coronary artery presenting with ventricular fibrillation cardiac arrest.

We report a case of an incidental finding of an anomalous left circumflex coronary artery arising from the right pulmonary artery that effectuated a ventricular fibrillation cardiac arrest in a woman aged 34 years. This rarity was detected during routine work-up to delineate the cause of this arrhythmia. Our patient had a background of double-outlet right ventricle and a ventricular septal defect, which was repaired with a Dacron patch and a left ventricle patch over to the aorta at age 14 months.

New-onset atrial fibrillation after anatomic lung resection: predictive factors, treatment and follow-up in a UK thoracic centre.

Objectives: Postoperative atrial fibrillation (POAF) increases morbidity, hospital stay and healthcare expenditure. This study aims to determine the perioperative factors correlating with POAF as well as to evaluate both treatment strategies and AF persistence beyond discharge.

Methods: The records of all patients undergoing anatomical lung resection over a 1-year period were retrospectively reviewed.