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after decannulation. Infection is associated with increased mortality and longer duration of ECMO support. Further efforts are needed to determine HAI reduction strategies in this high-risk patient population.

Recently, studies have revealed that salvage surgery after definitive chemoradiotherapy (CRT) for unresectable advanced non-small cell lung cancer (NSCLC) improves survival with acceptable surgical adverse events. Few reports exist regarding pneumonectomy or the bronchoplastic procedure in this setting.

Between 2008-2018, 27 patients (male, 21; median age, 61 years) underwent salvage surgery following definitive CRT for NSCLC. We investigated postoperative short- and long-term outcomes of salvage surgery and aimed to elucidate the feasibility of pneumonectomy or the bronchoplastic procedure.

The median radiation dose was 60 Gy. The median period from the last day for irradiation to the operative day was 8.5 months. Pneumonectomy was performed in 9 patients, including two carinal resections; lobectomy was performed in 18 patients, including five bronchoplasties. Bronchial wrapping was performed in 9 cases (33%), R0 resection was achieved in 24 (89%), and postoperative complications were detected in 16 (59%). While bronchopleural fistulas were found in only two patients who underwent pneumonectomy, arrythmia was observed more frequently in patients who underwent the bronchoplastic procedure (p=0.05). Regarding major complications, no relationship with any factors were found. The 90-day mortality was 0%. The 5-year overall and recurrence-free survival (RFS) were 63% and 27%, respectively. R0 resection was a good prognostic factor for RFS (p=0.001).

Perioperative short- and long-term outcomes of salvage surgery after definitive CRT for NSCLC were acceptable. Complete resection offered a better RFS. The bronchoplastic procedure or pneumonectomy should be considered as an option even after administration of high-dose CRT.

Perioperative short- and long-term outcomes of salvage surgery after definitive CRT for NSCLC were acceptable. Complete resection offered a better RFS. The bronchoplastic procedure or pneumonectomy should be considered as an option even after administration of high-dose CRT.

Repair of complete atrioventricular canal (CAVC) is often complicated by atrioventricular valve regurgitation, particularly of the left-sided valve. Understanding the three-dimensional (3D) structure of the atrioventricular canal annulus prior to repair may help to inform optimized repair. However, the 3D shape and movement of the CAVC annulus has yet to be quantified nor has it been rigorously compared to a normal mitral valve annulus.

The complete annuli of 43 patients with CAVC were modeled in 4 cardiac phases using transthoracic 3D echocardiograms and custom code. The annular structure was compared to the annuli of 20 normal pediatric mitral valves using 3D metrics and statistical shape analysis (Procrustes analysis).

The unrepaired CAVC annulus varied in shape significantly throughout the cardiac cycle. Procrustes analysis visually demonstrated that the average normalized CAVC annular shape is more planar than the normal mitral annulus. Quantitatively, the annular height to valve width ratio of the native left CAVC atrioventricular valve was significantly lower than that of a normal mitral valve in all systolic phases(p<0.001).

The left half of the CAVC annulus is more planar than that of a normal mitral valve with an annular height to valve width ratio similar to dysfunctional mitral valves. Given the known importance of annular shape to mitral valve function, further exploration of the association of 3D structure to valve function in CAVC is warranted.

The left half of the CAVC annulus is more planar than that of a normal mitral valve with an annular height to valve width ratio similar to dysfunctional mitral valves. Given the known importance of annular shape to mitral valve function, further exploration of the association of 3D structure to valve function in CAVC is warranted.

To evaluate the impact of surgical approach (thoraco-phreno-laparotomy, TPL vs thoracotomy-crura-splitting, TCS) on the outcomes of extent I thoracoabdominal aneurysm (TAAA) repair.

Patients were extracted from our aortic surgery database. Primary endpoint was need for tracheostomy. Secondary endpoints were operative mortality, myocardial infarction, stroke, spinal cord injury, de novo dialysis and major adverse events (composite of secondary endpoints and tracheostomy). Freedom from death and reoperation during follow up were calculated. Risk-adjustment was obtained with propensity-score matching and multivariable regression.

325 patients underwent extent I repair. Compared to TPL patients (n = 226), TCS patients (n = 99) had a higher rate of previous coronary revascularization (27.3% vs 14.2%, p 0.005), valvular disease (64.6% vs 50.4%, p 0.018), COPD (61.6% vs 28.3%, p 0.000) and a lower FEV-1 (46% vs 69%, p 0.000). In matched sample, TCS was associated to a decreased need for tracheostomy (4.0% vs 13.1%, p 0.035). 5-Ethynyluridine order The need for tracheostomy was predicted by female gender [OR 3.11 (95% CI 1.17, 8.30), p 0.023], FEV-1 [OR 0.95 (95% CI 0.91, 0.98), p 0.003], and TPL [OR 3.66 (95% CI 1.14, 11.73, p 0.029]. 5-year freedom from mortality and reoperation were similar.

In patients undergoing extent I TAAA repair, TCS is associated with decreased need for tracheostomy.

In patients undergoing extent I TAAA repair, TCS is associated with decreased need for tracheostomy.

We sought to determine if migraine is associated with increased risk of retinal artery occlusion (RAO).

Retrospective cohort study.

We reviewed a large insurance claims database for patients with migraine and matched control subjects without migraine between 2007 and 2016. Cox proportional hazard regression models were used to investigate the association between migraine and risk of all RAO, central RAO (CRAO), branch RAO (BRAO), and “other” RAO, which includes transient and partial RAO. Primary outcome measures included the incidence of all RAO, including CRAO, BRAO, and other RAO, after first migraine diagnosis.

There were 418,965 patients with migraine who met the study criteria and were included in the analysis with the appropriate matched control subjects. Among the 418,965 patients with migraine, 1060 (0.25%) were subsequently diagnosed with RAO, whereas only 335 (0.08%) of the patients without migraine were diagnosed with RAO. The hazard ratio (HR) for incident all RAO in patients with migraine compared with those without migraine was 3.