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Evaluation of your Genuine Plug-Based compared to an immediate Suture-Based Vascular Closing Gadget Strategy for Transfemoral Transcatheter Aortic Valve Replacement: The particular CHOICE-CLOSURE Randomized Clinical Trial.
A longer left superior pulmonary vein (LSPV) stump may increase the risk for postoperative cerebral infarction. Although the residual stump is generally longer after left upper lobectomy (LUL) than for other lobectomies, the length of the LSPV stump after LUL may be influenced by the anatomical relationship between the left atrial appendage (LAA) and the LSPV. Our aim in this study was to investigate the influence of this anatomical relationship on the residual length of the LSPV stump after LUL.

This was a retrospective analysis of 85 patients who underwent LUL at our institution, between January 2014 and March 2018. Based on pre-operative computed tomography (CT) images, the anatomical relationship between the LSPV and the LAA was classified into two patterns, namely an antero-superior and a postero-inferior pattern. The length of the LSPV stump for these two patterns was evaluated on postoperative CT images and compared between the two groups.

Of the 85 patients, 49 were classified in the antero-superior pattern and 36 in the postero-inferior pattern. The mean length of the LSPV stump after LUL, overall, was 21.9 (range, 15-38) mm, with the stump being significantly longer for the antero-posterior (24.2 mm) than postero-inferior (18.9 mm) pattern.

The anatomical relationship between the LSPV and LAA, identified on pre-operative CT images, was associated with the length of the LSPV stump after LUL.
The anatomical relationship between the LSPV and LAA, identified on pre-operative CT images, was associated with the length of the LSPV stump after LUL.
The aim of this study was to report our Institutional experience with extended sleeve lobectomy (ESL) in centrally located non-small cell lung cancer (NSCLC), focusing on technical details, post-operative results, recurrence and survival, to determine whether ESL can be accepted as a favorable alternative procedure to pneumonectomy (PN).

Twenty-two consecutive patients undergoing ESL for centrally located tumors from January 2014 to June 2019 were prospectively enrolled.

Six (27.3%) patients had been preoperatively considered unfit for PN. Neo-adjuvant chemotherapy was administered in 7 (31.8%) out of the 10 patients that showed a cN2 disease. According to Okada classification, 8 cases of type A ESL (resection of right upper plus middle lobe ± segment 6), one case of type B (resection of left upper lobe + segment 6) and 13 cases of type C (resection of left lower lobe + lingulectomy) ESL were performed. Concomitant pulmonary angioplasty was done in 7 (31.8%) patients. Complete resection was achieved in all patients. There was no postoperative mortality. Major postoperative complications developed in 2 (9.1%) patients (one small anastomotic dehiscence healed in few weeks, one pulmonary embolism). Complete long-term patency of the reconstructed airway was documented in all patients by fiber-optic bronchoscopy. At the median follow-up of 21 months (4-57 months), the recurrence rate was 54.5%, with 4 (18.2%) patients developing a loco-regional recurrence but no endobronchial or perianastomotic recurrence occurred. #link# The overall 3-year survival rate was 45% with a median survival of 33 months.

ESL is a safe and effective procedure that should be considered a favorable alternative to PN whenever it may guarantee a complete resection.
ESL is a safe and effective procedure that should be considered a favorable alternative to PN whenever it may guarantee a complete resection.
It is difficult to detect a common trunk of the left pulmonary vein (PV) preoperatively, which may cause intraoperative accidental complications. The purpose of this study is to establish a simple and reliable method of detecting a common trunk in preoperative computed tomography (CT) images.

A total of 428 patients who underwent thin-section CT preoperatively for left lung cancer at 4 institutions were reviewed. The characteristic findings of a common trunk in the axial view were considered by confirming the preoperative CT findings of cases that had been verified to have a common trunk based on intraoperative findings. The CT images were reviewed independently by two evaluators.

We found that the distance between the mediastinal side of the left lower bronchus and the junction of two left PVs was extremely short in the cases with a common trunk in the axial view. In a typical case, the axial section of the bronchus is close to the junction. Of the 416 patients that were evaluable among the 428 total patients, 26 (6.3%) were diagnosed as having a common trunk by both evaluators, and the diagnosis was coincident in 413 patients (99.2%). We were able to evaluate the surgical videos of 16 of the 26 patients, and a common trunk was confirmed in 15 patients (94%).

We established a simple and reliable method of detecting a common trunk of the left PV in the axial view on chest CT that was routinely performed prior to lung cancer surgery.
We established a simple and reliable method of detecting a common trunk of the left PV in the axial view on chest CT that was routinely performed prior to lung cancer surgery.
find more with arch involvement is a life-threatening condition, which requires immediate surgical attention. Emergent total arch replacement and root reconstruction is a technically demanding operation with varying outcomes based on surgeon experience. The human factors in total arch replacement in the emergent setting have never been systematically investigated. The ability of surgeons with low volumes to achieve acceptable results in their start-up period is not known.

From January 2013 to December 2016, patients with acute type A aortic dissection who underwent emergent total arch replacement with three surgeons were enrolled. Basic characteristics, procedural and postoperative outcomes were collected. The time of critical surgical steps and operative mortality were calculated using descriptive statistics and cumulative SUM (CUSUM) analysis.

A total of 300 patients (age 53.8±11.5 years, female 63, 21.0%) with acute type A aortic dissection underwent emergent total arch replacement.
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