Mitral Valve Surgery in The Elderly: Should We Treat Atrial Fibrillation Too?

Background: The study aim was to examine whether concomitant atrial fibrillation (AF) surgery at the time of mitral valve surgery in the elderly results in increased operative mortality (OM).

Methods: Medicare beneficiaries aged ≥65 years undergoing primary mitral valve repair or replacement between 2004 and 2006 were included. The cohort was divided into three groups: Group 1, AF- (n = 2,705); group 2, AF+AF surgery- (n = 2,119), and group 3, AF+AF surgery+ (n = 1,832).

Type A intramural hematoma in the setting of acute type B aortic dissection.

Type A intramural hematoma (IMH) is an uncommon entity, the pathophysiology of which is thought to be related to a contained hemorrhage within the medial layer of the aorta as a result of either rupture of the vasa vasorum or an atherosclerotic plaque. We present a case of type A IMH in the setting of acute type B aortic dissection with suspicion for malperfusion syndrome and discuss the treatment algorithm of this uncommon entity.

Influence of systemic lupus erythematosus on procedure selection and outcomes of patients undergoing isolated mitral valve surgery.

Background: Cardiovascular disease is the main cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). SLE as a risk factor for adverse outcomes during mitral surgery has not been studied. The purpose of this investigation was to compare procedure selection and outcomes of patients with and without SLE.

Sternotomy or bilateral thoracoscopy: pain and postoperative complications after lung-volume reduction surgery.

Objectives: Video-assisted thoracoscopic surgery (VATS) and median sternotomy (MS) are two approaches in lung-volume reduction surgery (LVRS). This study focused on the two surgical approaches with regard to postoperative pain.

Methods: In this prospective, non-randomized study, pain was measured preoperatively and postoperatively using the visual analog scale (VAS) and the brief pain inventory (BPI).

Is chronic obstructive pulmonary disease an independent risk factor for transfusion in coronary artery bypass graft surgery?

Objective: The literature is inconsistent regarding the role of chronic obstructive pulmonary disease (COPD) as a risk factor for blood product transfusion during coronary artery bypass graft (CABG). One reason may be lack of objective criteria to define COPD in previously published reports. We examined the role of COPD as a risk factor for transfusion using a strict definition based on objective pulmonary function test (PFT) data.

Long-term results and quality-of-life measures in the management of hyperhidrosis.

Primary focal hyperhidrosis has a significant, negative impact on quality of life, causing impairments in social, physical, leisure, and occupational activities. The outcome of different surgical and medical treatment modalities is best assessed by using a combination of tools. Quantitative tools include gravimetry, evaporimetry, and Minor's starch and iodine test.

Video-assisted thoracic surgical applications in thoracic trauma.

VATS is a valuable and safe way to manage many problems in thoracic trauma. It may allow earlier diagnosis and treatment of posttraumatic complications of chest injuries with less morbidity. This approach has already demonstrated advantages in such entities as retained hemothorax.

The effect of thoracoscopic sympathectomy on quality of life and symptom management of hyperhidrosis.

Background: Success with thoracoscopic sympathectomy (TS) for hyperhidrosis is 93% to 100%. We wished to determine if hyperhidrosis patients who do not undergo TS have decreased quality of life (QOL).

Study Design: Data collection was retrospective, with telephone calls to hyperhidrosis patients who qualified for sympathectomy.

Gastrointestinal-related complications after major lung surgery.

Numerous factors increase the risk for GI complications in patients undergoing lung resection. It seems that the more debilitated the patient and the more extensive the COPD, the higher the risk. The most commonly reported cause of mortality after lung surgery is multi-organ failure accompanying respiratory failure.

Endobronchial valves for treatment of bronchopleural fistula.

Endobronchial valves have recently emerged as a possible alternative to lung volume reduction surgery to treat incapacitating emphysema. The early experience with placement of these valves has been shown to be safe, with short-term improvements of quality of life in this patient population. We report a case in which these valves were used to treat a patient with a persistent air leak.

Acute and chronic reduction of pulmonary function after lung surgery.

Pulmonary function is affected by several variables. The more marginal the patient, the more important the preoperative and perioperative assessment becomes. VATS might be tolerated well with regard to pulmonary function in the early postoperative period.