Advances in medical systems for treating parotid tumors

42% vs. 26%; both P60 years, atrial fibrillation and non-saddle embolus were associated with increased odds of mortality. CONCLUSIONS In this contemporary, real-world study, mortality occurred in 19.8% of patients undergoing surgical embolectomy for acute pulmonary embolism. This represents a significant improvement compared to traditional outcomes and supports the role of surgery in the multidisciplinary treatment of this high-risk condition. BACKGROUND Airway management during repair of laryngotracheal stenosis is demanding and there is currently no accepted standard of care. Recently, an increasing number of airway centers have started to use a laryngeal mask until the airway is surgically exposed and cross-table ventilation can be initiated. However, detailed data on this approach are missing in the literature. METHODS All patients receiving laryngotracheal surgery from November 2011 until October 2018 were retrospectively included in this single center study, except for patients who presented with a pre-existing tracheostomy at time of surgery. Airway management uniformly consisted of laryngeal mask ventilation until cross-table ventilation was established. Clinical variables, perioperative complications and airway complications were analyzed. MRT68921 RESULTS A total of 108 patients (65 female, 43 male) receiving tracheal resection (n=50), cricotracheal resection (n=49) or single-stage laryngotracheal reconstruction (n=9) were included in the analysis. 23 (21.3%) of the included patients had malignant disease and 85 (78.7%) patients a benign pathology. 85.1% of patients in the subgroup with subglottic disease had high grade stenosis (Myer-Cotton III°). Airway management with a laryngeal mask was successful in all except one patient (99.1%). Mean SpO2 and mean end-tidal CO2 during laryngeal mask ventilation was 98.7±2.4% and 34.8±7.6 mmHg, respectively. At the end of surgery, 95 patients (88%) were successfully weaned from the respirator using the laryngeal mask. CONCLUSIONS The laryngeal mask as primary airway device is feasible and safe in patients undergoing laryngotracheal surgery even in cases with high-grade stenosis. BACKGROUND Coronary artery disease (CAD) has historically been responsible for more deaths in women than in men and previous studies have suggested sex differences in revascularization approaches and outcomes. We sought to compare sex-specific adverse events in patients who underwent percutaneous or surgical revascularization for multivessel CAD. METHODS All patients at a single institution undergoing PCI or CABG for multivessel CAD between 2011 and 2018 were included. Propensity score matching was utilized to compare patients with similar baseline characteristics. Outcomes included death, major adverse cardiac and cerebrovascular events (MACCE), repeat revascularization, and readmissions. RESULTS Of the 6163 patients, 1679 (27.2%) were female. Males were more likely to have 3-vessel disease (71.9% vs 68.6%, p=0.002) and to undergo complete revascularization (69.9% vs 66.4%, p=0.008). Female sex was associated with an increased hazard for death (HR 1.16, p=0.03) and MACCE (HR 1.16, p=0.02) but not repeat revascularization (HR 1.23, p=0.16). In the matched cohorts, female sex was associated with lower survival at 1 year (90.63% vs 93.12%, p=0.01) but not 5 years (76.64% vs 77.33%, p=0.20). Similarly, freedom from MACCE was lower in females at 1 year (87.79% vs 90.19%, p=0.03) but was comparable at 5 years (73.22% vs 74.3%, p=0.10). CONCLUSIONS In a matched analysis pooling percutaneous and surgical revascularization, female sex was associated with worse outcomes at 1 year though there were no sex differences at 5 years of follow-up. Increasing CABG utilization and the completeness of revascularization in females may be targets for improving 1-year survival and freedom from MACCE. BACKGROUND Reoperative cardiac surgery has been associated with increased morbidity and mortality. Large propensity matched series comparing all first-time and redo cardiac operations are lacking. The primary objective of the current study was to provide detailed outcomes and risk factors for mortality and readmissions following reoperative cardiac surgery. METHODS All patients who underwent cardiac surgery from 2011-2017 were included. Propensity matching yielded equitable cohorts. Multivariable Cox regression analysis was performed to identify independent predictors of 30-day, 1-year, and 5-year mortality and readmissions. RESULTS 14,151 patients underwent cardiac surgery, of which 1700 (12%) had reoperative cardiac surgery. There were significantly (p24 hr) (20% vs 17%; p=0.02) were increased for the reoperative cohort. On multivariable analysis for propensity matched cohorts, reoperation was an independent predictor of mortality at 30-days [HR 1.36 (1.05, 1.75); p=0.02], 1-year [HR 1.30 (1.09, 1.55); p=0.004], and 5-years [HR 1.30 (1.14, 1.5); p=0.0002]. CONCLUSIONS After risk adjusting for baseline characteristics, the need for reoperation was an independent predictor of both short and long-term mortality following reoperative cardiac surgery. These data are relevant when considering alternative therapies such as percutaneous coronary or transcatheter valve interventions. PURPOSE In children with a mitral annulus too small to accommodate traditional prostheses, surgical implantation of stent-based valves is a promising option. However, no reliable pre-operative methods exist to guide patient selection, device sizing and positioning. We describe a novel methodology to visualize and quantify device fit in three-dimensional echocardiogram (3DE)-derived heart models. DESCRIPTION Heart models were created from existing pre-operative 3DE using custom software. Valve models were virtually implanted into the models and both device fit and left ventricular outflow tract (LVOT) area were quantified. EVALUATION The 3DE of three patients who underwent Melody valve placement in the mitral position were retrospectively modeled - one with left ventricular outflow tract obstruction(LVOTO), one with perivalvar leak, and one without complications. In all cases 2D measurements underestimated 3D annular dimensions, and the patient with clinical LVOT obstruction had the lowest predicted LVOT area/Aortic area ratio (0.