Cardiothoracic Surgery

A special issue of Surgeries (ISSN 2673-4095).

Deadline for manuscript submissions: 20 January 2025 | Viewed by 7187

Special Issue Editors


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Guest Editor
Colleges of Medicine and Graduate Studies, Northeast Ohio Medical University, Rootstown, Rootstown, OH 44272, USA
Interests: clinical interest is cardiothoracic surgery & heart failure; long-term mechanical ventricular support; cardiothoracic critical care; cardiovascular quality and outcomes

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Guest Editor
National Institute of Cardiology Ambulatory Care Unit, 04-628 Warsaw, Poland
Interests: cardiology; valve disease; hypertension; Heart Failure; cardiac surgery; postoperative complications
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Special Issue Information

Dear Colleagues,

Cardiothoracic procedures are often lifesaving operations. There are effective treatments, including transplantation, for almost all cardiac and thoracic diseases that can be performed with a low risk of morbidity and mortality. Cardiac surgeons are commonly challenged with weighing the potential risk and the potential benefit of a surgical procedure.
It is our privilege to invite experts in the field to share their expertise and submit new ideas and cutting-edge research to this Special Issue.

Dr. Michael S Firstenberg
Dr. Piotr Duchnowski
Guest Editors

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Published Papers (5 papers)

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8 pages, 6313 KiB  
Case Report
Indolent Adenocarcinoma In Situ Mistaken as Aggressive during Lung Cancer Screening Program: To Heal or to Harm?
by Riccardo Orlandi, Giovanni Mattioni, Luigi Rolli and Ugo Pastorino
Surgeries 2024, 5(3), 867-874; https://doi.org/10.3390/surgeries5030070 - 16 Sep 2024
Viewed by 375
Abstract
Background: Low-dose computed tomography-based lung cancer screening (LCS) has demonstrated efficacy in reducing lung cancer mortality. However, concerns about overdiagnosis and overtreatment hinder global LCS implementation. Methods: Here, we report the unique case of a slow-growing 1 cm pure ground-glass opacity (GGO) of [...] Read more.
Background: Low-dose computed tomography-based lung cancer screening (LCS) has demonstrated efficacy in reducing lung cancer mortality. However, concerns about overdiagnosis and overtreatment hinder global LCS implementation. Methods: Here, we report the unique case of a slow-growing 1 cm pure ground-glass opacity (GGO) of the lung, known for 15 years, which unexpectedly developed into a 5 cm mixed GGO within 1 year, with an increased solid component and FDG-PET uptake. Results: The patient, asymptomatic, underwent right upper lobectomy and lymphadenectomy, even complicated with postoperative chylothorax, later revealing to be affected by only an unchanged adenocarcinoma in situ (AIS). Conclusions: This case serves as a reminder of the potential behavior of pre-invasive lesions, which can mimic invasive neoplasia and may lead to overtreatment, and underscores the challenge of distinguishing indolent lesions from potentially aggressive malignancies in LCS, highlighting the need for the ongoing refinement of LCS protocols to mitigate this risk. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery)
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9 pages, 1826 KiB  
Case Report
Pleural Effusion following Yoga: A Report of Delayed Spontaneous Chylothorax and a Brief Review of Unusual Cases in the Literature
by Gabriel Hunduma, Paolo Albino Ferrari, Farouk Alreshaid, Tayyeba Kiran, Aiman Alzetani and Alessandro Tamburrini
Surgeries 2024, 5(2), 288-296; https://doi.org/10.3390/surgeries5020026 - 25 Apr 2024
Viewed by 754
Abstract
Chylothorax is a rare condition where the extravasated chyle accumulates into the pleural space. It is most commonly associated with malignancies, infective or inflammatory disorders and iatrogenic causes. Extremely rarely, it could occur spontaneously. We present the case of a healthy 40-year-old woman [...] Read more.
Chylothorax is a rare condition where the extravasated chyle accumulates into the pleural space. It is most commonly associated with malignancies, infective or inflammatory disorders and iatrogenic causes. Extremely rarely, it could occur spontaneously. We present the case of a healthy 40-year-old woman who presented with acute right shoulder and neck pain associated with shortness of breath and loss of consciousness. This was preceded by a yoga class two weeks prior. Chest imaging showed right pleural effusion, and tapping revealed a milky fluid which was confirmed to be chylothorax. Conservative management failed and the patient was successfully treated with video-assisted thoracoscopic drainage, thoracic duct ligation and mechanical pleurodesis. Chylothorax association with yoga is not reported in the literature. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery)
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8 pages, 1420 KiB  
Case Report
An Unexpected 12.6 Centimeter Nail in the Thorax Damaging Vital Structures: A Case Report “Nailed It”
by Thomas H. Avedissian, Daniel J. F. M. Thuijs, Lucas Timmermans, Alexander P. W. M. Maat and Edris A. F. Mahtab
Surgeries 2023, 4(1), 38-45; https://doi.org/10.3390/surgeries4010006 - 31 Jan 2023
Viewed by 1409
Abstract
We report a patient who was referred to the emergency room with pulmonary complaints and where a computed tomography (CT) scan showed an unexpected 12.6 cm nail in the thorax penetrating part of the left pulmonary upper lobe, the left pulmonary artery, the [...] Read more.
We report a patient who was referred to the emergency room with pulmonary complaints and where a computed tomography (CT) scan showed an unexpected 12.6 cm nail in the thorax penetrating part of the left pulmonary upper lobe, the left pulmonary artery, the left main bronchus, and the descending aorta, which had been in situ for at least three days. The quickly deteriorating patient had to be transferred to a tertiary academic hospital where the nail was successfully surgically removed. The comprehensive description of this unique case with a discussion of the critical decision moments could render insights into the management of challenging trauma cases. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery)
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13 pages, 962 KiB  
Protocol
Preoperative Nutritional Optimization and Physical Exercise for Patients Scheduled for Elective Implantation for a Left-Ventricular Assist Device—The PROPER-LVAD Study
by Aileen Hill, Vera von Dossow, Daren K. Heyland, Rolf Rossaint, Patrick Meybohm, Henrik Fox, Michiel Morshuis, Gunnar Elke, Bernd Panholzer, Assad Haneya, Andreas Böning, Bernd Niemann, Rashad Zayat, Ajay Moza and Christian Stoppe
Surgeries 2022, 3(4), 284-296; https://doi.org/10.3390/surgeries3040031 - 30 Sep 2022
Cited by 4 | Viewed by 2264
Abstract
Background: Prehabilitation is gaining increasing interest and shows promising effects on short- and long-term outcomes among patients undergoing major surgery. The effect of multimodal, interdisciplinary prehabilitation has not yet been studied in patients with severe heart failure scheduled for the implantation of a [...] Read more.
Background: Prehabilitation is gaining increasing interest and shows promising effects on short- and long-term outcomes among patients undergoing major surgery. The effect of multimodal, interdisciplinary prehabilitation has not yet been studied in patients with severe heart failure scheduled for the implantation of a left-ventricular assist device (LVAD). Methods: This randomized controlled multi-center study evaluates the effect of preoperative combined optimization of nutritional and functional status. Patients in the intervention group are prescribed daily in-bed cycling and oral nutrition supplements (ONS) from study inclusion until the day before LVAD-implantation. Patients in the control group receive standard of care treatment. The primary outcomes for the pilot study that involves 48 patients are safety (occurrence of adverse events), efficacy (group separation regarding the intake of macronutrients), feasibility of the trial protocol (compliance (percentage of received interventions) and confirmation of recruitment rates. Secondary outcomes include longitudinal measurements of muscle mass, muscle strength, physical function and quality of life, next to traditional clinical outcomes (30-day mortality, hospital and ICU length of stay, duration of mechanical ventilation and number of complications and infections). If the pilot study is successful, a larger confirmatory, international multicenter study is warranted. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery)
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6 pages, 2111 KiB  
Case Report
A Reverse Thymic Fat Pad Flap to Cover the Anastomosis of an Extended Tracheal Resection Following Induction Chemotherapy: A Challenging Case Report
by Maria Giovanna Mastromarino, Giuseppe Cardillo and Massimo Osvaldo Jaus
Surgeries 2022, 3(3), 271-276; https://doi.org/10.3390/surgeries3030029 - 14 Sep 2022
Viewed by 1493
Abstract
Extended tracheal resection after neoadjuvant chemotherapy is rarely described in patients with tracheal cancer. Controversies still exist among surgeons about the length of tracheal resectability and possible harmful anastomotic complications. Different vascularized tissue flaps can be used to protect the anastomotic suture line. [...] Read more.
Extended tracheal resection after neoadjuvant chemotherapy is rarely described in patients with tracheal cancer. Controversies still exist among surgeons about the length of tracheal resectability and possible harmful anastomotic complications. Different vascularized tissue flaps can be used to protect the anastomotic suture line. We reported a 67-year-old patient with middle tracheal squamous cell carcinoma treated by induction chemotherapy followed by a successful extended tracheal resection. The anastomosis was covered by a reversed thymic fat pad flap to prevent the erosion of adjacent brachiocephalic vessels. Postoperative concurrent chemoradiation did not threaten the integrity of the suture line. Careful tracheal dissection and accurate release manoeuvres are mandatory to achieve a tension-limited anastomosis. Extended tracheal resection may be safely performed after induction chemotherapy, with excellent long-term outcomes. A thymic fat flap seems to be beneficial to suture-line healing. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery)
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