Effects of early steroid withdrawal after heart transplantation.

Background: Managing immunosuppression is a significant aspect of posttransplantation patient care. Previously, our institution reported that prednisone could be withdrawn in cardiac allograft recipients without jeopardizing midterm survival. We returned to this group of patients to investigate the long-term effects of our steroid taper protocol.

Contemporary techniques and safety of cardiovascular procedures in the surgical management of renal cell carcinoma with tumor thrombus.

Objective: Renal cell carcinomas often form venous thrombi that extend into the vena cava. Frequently, cardiovascular consultation is necessary for complete surgical excision. We sought to investigate the risk factors, surgical techniques, and outcomes of patients treated for renal cell carcinoma with venous extension.

Routine computed tomography screening of the chest in high-risk cardiac transplant recipients may improve survival.

Background: Multiple studies have demonstrated an increased incidence of lung cancer in the heart transplant population. We reviewed our cardiac transplantation experience with respect to the development of bronchogenic carcinoma and explored the role of routine chest computed tomography (CT) in its surveillance.

Methods: We performed a review of our cardiac transplantation experience, highlighting the incidence of lung cancer, and we analyzed our recent experience with screening chest CT in lung cancer surveillance in this patient group.

Improved pain management outcomes with continuous infusion of a local anesthetic after thoracotomy.

Objective: We sought to determine the effectiveness of an incisional infusion of local anesthetics through a continuous-infusion elastomeric pump for the management of postoperative pain after thoracotomy.

Methods: We performed a retrospective comparative analysis of 110 patients undergoing thoracotomies between November 1999 and March 2003. Postoperative pain management with a continuous-infusion elastomeric pump providing local anesthetic into the incisional area was compared with a single-shot epidural in combination with continuous local anesthetic infusion and continuous thoracic epidural infusion.

Surgical treatment of thoracic empyema in HIV-infected patients: severity and treatment modality is associated with CD4 count status.

Objectives: Patients infected with HIV have an increased propensity for developing thoracic empyemas secondary to their susceptibility to polymicrobial pulmonary infections. We performed an assessment of the clinical outcomes of HIV patients undergoing surgical treatment of thoracic empyemas and reviewed the microbiology of these infections.

Methods: We completed a retrospective analysis of the patients who had been referred for surgical treatment of thoracic empyemas over an 11-year period, ending in 2002.