Descending Aortic Translocation for Relief of Distal Tracheal and Proximal Bronchial Compression
Background A descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main bronchi. Posterior aortopexy has had inconsistent results. Methods A retrospective review determined that, since 2004, 5 children have undergone...
Saved in:
Published in | The Annals of thoracic surgery Vol. 102; no. 3; pp. 859 - 862 |
---|---|
Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Netherlands
Elsevier Inc
01.09.2016
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Background A descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main bronchi. Posterior aortopexy has had inconsistent results. Methods A retrospective review determined that, since 2004, 5 children have undergone descending aortic translocation at Texas Children’s Hospital. The average age at the time of surgical treatment was 4.2 years, and all patients presented with recurring respiratory illness requiring hospitalization. All patients had preoperative imaging (4 patients with computed tomography scans and 1 with magnetic resonance imaging) confirming a compromised airway caused by a midline aorta, and 4 of the 5 patients had perioperative bronchoscopy. Three patients had a right-dominant double aortic arch. Descending aortic translocation was performed through a midline sternotomy with cardiopulmonary bypass and deep hypothermia. The proximal descending aorta was transected distal to the subclavian artery, brought up through the transverse sinus caudad to the tracheal carina and pulmonary artery, and anastomosed in an end-to-side fashion to the ascending aorta. Results Mean cardiopulmonary bypass was 144.8 ± 32.6 minutes, with an aortic cross-clamp time of 59 ± 40.9. Absence of perfusion to the descending thoracic aorta averaged 44.4 ± 13.7 minutes. Concomitant procedures were performed in 4 of the 5 patients. At a median follow-up of 26 months (range, 3 to 101 months), all patients had resolution of symptoms. Conclusions A midline descending aorta can cause compression of the tracheal carina and proximal bronchi, with debilitating symptoms. Translocation of the descending aorta is a reliable procedure that relieves the compression and results in long-term resolution of symptoms. |
---|---|
AbstractList | Background A descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main bronchi. Posterior aortopexy has had inconsistent results. Methods A retrospective review determined that, since 2004, 5 children have undergone descending aortic translocation at Texas Children’s Hospital. The average age at the time of surgical treatment was 4.2 years, and all patients presented with recurring respiratory illness requiring hospitalization. All patients had preoperative imaging (4 patients with computed tomography scans and 1 with magnetic resonance imaging) confirming a compromised airway caused by a midline aorta, and 4 of the 5 patients had perioperative bronchoscopy. Three patients had a right-dominant double aortic arch. Descending aortic translocation was performed through a midline sternotomy with cardiopulmonary bypass and deep hypothermia. The proximal descending aorta was transected distal to the subclavian artery, brought up through the transverse sinus caudad to the tracheal carina and pulmonary artery, and anastomosed in an end-to-side fashion to the ascending aorta. Results Mean cardiopulmonary bypass was 144.8 ± 32.6 minutes, with an aortic cross-clamp time of 59 ± 40.9. Absence of perfusion to the descending thoracic aorta averaged 44.4 ± 13.7 minutes. Concomitant procedures were performed in 4 of the 5 patients. At a median follow-up of 26 months (range, 3 to 101 months), all patients had resolution of symptoms. Conclusions A midline descending aorta can cause compression of the tracheal carina and proximal bronchi, with debilitating symptoms. Translocation of the descending aorta is a reliable procedure that relieves the compression and results in long-term resolution of symptoms. A descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main bronchi. Posterior aortopexy has had inconsistent results. A retrospective review determined that, since 2004, 5 children have undergone descending aortic translocation at Texas Children’s Hospital. The average age at the time of surgical treatment was 4.2 years, and all patients presented with recurring respiratory illness requiring hospitalization. All patients had preoperative imaging (4 patients with computed tomography scans and 1 with magnetic resonance imaging) confirming a compromised airway caused by a midline aorta, and 4 of the 5 patients had perioperative bronchoscopy. Three patients had a right-dominant double aortic arch. Descending aortic translocation was performed through a midline sternotomy with cardiopulmonary bypass and deep hypothermia. The proximal descending aorta was transected distal to the subclavian artery, brought up through the transverse sinus caudad to the tracheal carina and pulmonary artery, and anastomosed in an end-to-side fashion to the ascending aorta. Mean cardiopulmonary bypass was 144.8 ± 32.6 minutes, with an aortic cross-clamp time of 59 ± 40.9. Absence of perfusion to the descending thoracic aorta averaged 44.4 ± 13.7 minutes. Concomitant procedures were performed in 4 of the 5 patients. At a median follow-up of 26 months (range, 3 to 101 months), all patients had resolution of symptoms. A midline descending aorta can cause compression of the tracheal carina and proximal bronchi, with debilitating symptoms. Translocation of the descending aorta is a reliable procedure that relieves the compression and results in long-term resolution of symptoms. BACKGROUNDA descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main bronchi. Posterior aortopexy has had inconsistent results.METHODSA retrospective review determined that, since 2004, 5 children have undergone descending aortic translocation at Texas Children's Hospital. The average age at the time of surgical treatment was 4.2 years, and all patients presented with recurring respiratory illness requiring hospitalization. All patients had preoperative imaging (4 patients with computed tomography scans and 1 with magnetic resonance imaging) confirming a compromised airway caused by a midline aorta, and 4 of the 5 patients had perioperative bronchoscopy. Three patients had a right-dominant double aortic arch. Descending aortic translocation was performed through a midline sternotomy with cardiopulmonary bypass and deep hypothermia. The proximal descending aorta was transected distal to the subclavian artery, brought up through the transverse sinus caudad to the tracheal carina and pulmonary artery, and anastomosed in an end-to-side fashion to the ascending aorta.RESULTSMean cardiopulmonary bypass was 144.8 ± 32.6 minutes, with an aortic cross-clamp time of 59 ± 40.9. Absence of perfusion to the descending thoracic aorta averaged 44.4 ± 13.7 minutes. Concomitant procedures were performed in 4 of the 5 patients. At a median follow-up of 26 months (range, 3 to 101 months), all patients had resolution of symptoms.CONCLUSIONSA midline descending aorta can cause compression of the tracheal carina and proximal bronchi, with debilitating symptoms. Translocation of the descending aorta is a reliable procedure that relieves the compression and results in long-term resolution of symptoms. |
Author | Mery, Carlos M., MD, MPH De León, Luis E., MD Adachi, Iki, MD Heinle, Jeffrey S., MD Thompson, Jess L., MD McKenzie, E. Dean, MD Fraser, Charles D., MD Roeser, Mark E., MD |
Author_xml | – sequence: 1 fullname: McKenzie, E. Dean, MD – sequence: 2 fullname: Roeser, Mark E., MD – sequence: 3 fullname: Thompson, Jess L., MD – sequence: 4 fullname: De León, Luis E., MD – sequence: 5 fullname: Adachi, Iki, MD – sequence: 6 fullname: Heinle, Jeffrey S., MD – sequence: 7 fullname: Mery, Carlos M., MD, MPH – sequence: 8 fullname: Fraser, Charles D., MD |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27209610$$D View this record in MEDLINE/PubMed |
BookMark | eNqNUcFu1DAQtVAR3RZ-AeXIJcFjJ058QWq3UJAqgWDvxmuPWS9Ze7ETRP--jraAxImTZ-z33njeuyBnIQYkpALaAAXxet_oaReTNnlODSs3DWUNbdsnZAVdx2rBOnlGVpRSXrey787JRc770rLy_Iycs55RKYCuyNcbzAaD9eFbdRXT5E21STrkMRo9-RgqF1P1GUeProquuvF50uMCMTsshQ62-pTiL38ozXWKwex8qdbxcEyYcxF4Tp46PWZ88Xheks27t5v1-_ru4-2H9dVdbdpeTjUHh64HazoYRLtl4AbeacvtlmPbW4tCImUoO3RMIAXeGkYH4cB1QsqWX5JXJ9ljij9mzJM6-LLYOOqAcc4KBuCSAhNQoMMJalLMOaFTx1T-n-4VULXYq_bqr71qsVdRpoq9hfryccq8PaD9Q_ztZwFcnwBYVv3pMalsPAaD1ic0k7LR_8-UN_-ImNEHb_T4He8x7-OcQrFSgcqFoL4sMS8pgygBs0HyBwncqDk |
CitedBy_id | crossref_primary_10_1016_j_jtcvs_2023_06_013 crossref_primary_10_1017_S1047951118000665 crossref_primary_10_1053_j_semtcvs_2018_02_031 crossref_primary_10_1016_j_athoracsur_2021_04_105 crossref_primary_10_1177_02184923231186915 crossref_primary_10_7759_cureus_13015 crossref_primary_10_1016_j_athoracsur_2022_02_020 crossref_primary_10_1053_j_semtcvs_2019_05_003 crossref_primary_10_1016_j_athoracsur_2016_02_090 crossref_primary_10_1017_S1047951123003311 crossref_primary_10_1111_jocs_16811 crossref_primary_10_1177_2150135118815027 |
Cites_doi | 10.1016/S0022-5223(96)70269-6 10.1177/000348949710600603 10.2214/ajr.164.3.7863899 10.1007/s002470050404 10.1016/j.jpedsurg.2008.11.062 10.1016/S0025-6196(12)60898-2 10.1053/j.optechstcvs.2013.03.001 10.1046/j.1460-9592.2003.01192.x |
ContentType | Journal Article |
Copyright | The Society of Thoracic Surgeons 2016 The Society of Thoracic Surgeons Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Copyright_xml | – notice: The Society of Thoracic Surgeons – notice: 2016 The Society of Thoracic Surgeons – notice: Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
DOI | 10.1016/j.athoracsur.2016.02.044 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef MEDLINE - Academic |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef MEDLINE - Academic |
DatabaseTitleList | MEDLINE - Academic MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
EISSN | 1552-6259 |
EndPage | 862 |
ExternalDocumentID | 10_1016_j_athoracsur_2016_02_044 27209610 S0003497516002289 1_s2_0_S0003497516002289 |
Genre | Journal Article |
GroupedDBID | --- --K .1- .55 .FO .GJ 0R~ 1B1 1P~ 1~5 23M 3O- 4.4 457 4G. 53G 5GY 5RE 5VS 6J9 7-5 71M AAEDT AAEDW AAEJM AALRI AAQFI AAQQT AAQXK AAXUO ABJNI ABLJU ABMAC ABOCM ACGFO ACGFS ACIUM ACRZS ADBBV ADMUD ADPAM AENEX AEVXI AFCTW AFFNX AFRHN AFTJW AGHFR AI. AITUG AJJEV AJUYK AKRWK ALMA_UNASSIGNED_HOLDINGS AMRAJ ASPBG AVWKF AZFZN BAWUL BELOY C5W CS3 DIK E3Z EBS EFJIC EJD F5P FDB FEDTE FGOYB GBLVA GX1 HVGLF HZ~ IH2 IHE J1W J5H K-O KOM L7B M41 MO0 N9A NQ- O9- OA- OK1 OL. OVD P2P P6G PC. R2- RIG ROL RPZ SES SSZ TEORI TR2 UDS UNMZH UV1 VH1 W8F X7M XH2 XPP Z5R ZGI ZXP AAIAV AGZHU AHPSJ ALXNB ZA5 CGR CUY CVF ECM EIF NPM AAYXX ACRPL ADNMO CITATION 7X8 |
ID | FETCH-LOGICAL-c479t-31fef71dc51864b21f835ad3db3e47dde69e02e95ef26e0134c2086f1f569943 |
ISSN | 0003-4975 |
IngestDate | Fri Aug 16 04:38:15 EDT 2024 Fri Dec 06 01:44:32 EST 2024 Tue Aug 27 13:47:19 EDT 2024 Fri Feb 23 02:30:26 EST 2024 Tue Oct 15 14:35:15 EDT 2024 |
IsDoiOpenAccess | false |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 3 |
Language | English |
License | Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c479t-31fef71dc51864b21f835ad3db3e47dde69e02e95ef26e0134c2086f1f569943 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
OpenAccessLink | http://www.annalsthoracicsurgery.org/article/S0003497516002289/pdf |
PMID | 27209610 |
PQID | 1813901261 |
PQPubID | 23479 |
PageCount | 4 |
ParticipantIDs | proquest_miscellaneous_1813901261 crossref_primary_10_1016_j_athoracsur_2016_02_044 pubmed_primary_27209610 elsevier_sciencedirect_doi_10_1016_j_athoracsur_2016_02_044 elsevier_clinicalkeyesjournals_1_s2_0_S0003497516002289 |
PublicationCentury | 2000 |
PublicationDate | 2016-09-01 |
PublicationDateYYYYMMDD | 2016-09-01 |
PublicationDate_xml | – month: 09 year: 2016 text: 2016-09-01 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | Netherlands |
PublicationPlace_xml | – name: Netherlands |
PublicationTitle | The Annals of thoracic surgery |
PublicationTitleAlternate | Ann Thorac Surg |
PublicationYear | 2016 |
Publisher | Elsevier Inc |
Publisher_xml | – name: Elsevier Inc |
References | Ruzmetov, Vijay, Rodefeld (bib2) 2009; 44 Russell, Rastatter, Backer (bib8) 2013; 18 Donnelly, Bisset, McDermott (bib4) 1995; 164 Goldman, Rimell, Meza, Newman (bib5) 1997; 106 Robotin, Bruniaux, Serraf (bib7) 1996; 112 Kaussman, Geva, McGowan (bib1) 2004; 14 van Son, Julsrud, Hagler (bib3) 1993; 68 Hungate, Newman, Meza (bib6) 1998; 28 27549522 - Ann Thorac Surg. 2016 Sep;102(3):862-863 Kaussman (10.1016/j.athoracsur.2016.02.044_bib1) 2004; 14 Hungate (10.1016/j.athoracsur.2016.02.044_bib6) 1998; 28 Robotin (10.1016/j.athoracsur.2016.02.044_bib7) 1996; 112 Goldman (10.1016/j.athoracsur.2016.02.044_bib5) 1997; 106 Russell (10.1016/j.athoracsur.2016.02.044_bib8) 2013; 18 van Son (10.1016/j.athoracsur.2016.02.044_bib3) 1993; 68 Donnelly (10.1016/j.athoracsur.2016.02.044_bib4) 1995; 164 Ruzmetov (10.1016/j.athoracsur.2016.02.044_bib2) 2009; 44 |
References_xml | – volume: 18 start-page: 15 year: 2013 end-page: 31 ident: bib8 article-title: Aortic uncrossing procedure for circumflex aorta publication-title: Oper Tech Thorac Cardiovasc Surg contributor: fullname: Backer – volume: 44 start-page: 1328 year: 2009 end-page: 1332 ident: bib2 article-title: Follow-up of surgical correction of aortic arch anomalies causing tracheoesophageal compression: a 38-year single institution experience publication-title: J Pediatr Surg contributor: fullname: Rodefeld – volume: 14 start-page: 60 year: 2004 end-page: 74 ident: bib1 article-title: Cardiovascular causes of airway compression publication-title: Pediatr Anesth contributor: fullname: McGowan – volume: 106 start-page: 461 year: 1997 end-page: 465 ident: bib5 article-title: Diagnosis and management of left mainstem bronchus compression publication-title: Ann Otol Rhino Laryngol contributor: fullname: Newman – volume: 112 start-page: 415 year: 1996 end-page: 423 ident: bib7 article-title: Unusual forms of tracheobronchial compression in infants with congenital heart disease publication-title: J Thorac Cardiovasc Surg contributor: fullname: Serraf – volume: 68 start-page: 1056 year: 1993 end-page: 1063 ident: bib3 article-title: Surgical treatment of vascular rings: the Mayo Clinic experience publication-title: Mayo Clin Proc contributor: fullname: Hagler – volume: 164 start-page: 705 year: 1995 end-page: 707 ident: bib4 article-title: Anomalous midline location of the descending aorta: a cause of compression of the carina and left mainstem bronchus in infants publication-title: AJR Am J Roentgenol contributor: fullname: McDermott – volume: 28 start-page: 527 year: 1998 end-page: 532 ident: bib6 article-title: Left mainstem bronchial narrowing: a vascular compression syndrome? publication-title: Pediatr Radiol contributor: fullname: Meza – volume: 112 start-page: 415 year: 1996 ident: 10.1016/j.athoracsur.2016.02.044_bib7 article-title: Unusual forms of tracheobronchial compression in infants with congenital heart disease publication-title: J Thorac Cardiovasc Surg doi: 10.1016/S0022-5223(96)70269-6 contributor: fullname: Robotin – volume: 106 start-page: 461 year: 1997 ident: 10.1016/j.athoracsur.2016.02.044_bib5 article-title: Diagnosis and management of left mainstem bronchus compression publication-title: Ann Otol Rhino Laryngol doi: 10.1177/000348949710600603 contributor: fullname: Goldman – volume: 164 start-page: 705 year: 1995 ident: 10.1016/j.athoracsur.2016.02.044_bib4 article-title: Anomalous midline location of the descending aorta: a cause of compression of the carina and left mainstem bronchus in infants publication-title: AJR Am J Roentgenol doi: 10.2214/ajr.164.3.7863899 contributor: fullname: Donnelly – volume: 28 start-page: 527 year: 1998 ident: 10.1016/j.athoracsur.2016.02.044_bib6 article-title: Left mainstem bronchial narrowing: a vascular compression syndrome? publication-title: Pediatr Radiol doi: 10.1007/s002470050404 contributor: fullname: Hungate – volume: 44 start-page: 1328 year: 2009 ident: 10.1016/j.athoracsur.2016.02.044_bib2 article-title: Follow-up of surgical correction of aortic arch anomalies causing tracheoesophageal compression: a 38-year single institution experience publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2008.11.062 contributor: fullname: Ruzmetov – volume: 68 start-page: 1056 year: 1993 ident: 10.1016/j.athoracsur.2016.02.044_bib3 article-title: Surgical treatment of vascular rings: the Mayo Clinic experience publication-title: Mayo Clin Proc doi: 10.1016/S0025-6196(12)60898-2 contributor: fullname: van Son – volume: 18 start-page: 15 year: 2013 ident: 10.1016/j.athoracsur.2016.02.044_bib8 article-title: Aortic uncrossing procedure for circumflex aorta publication-title: Oper Tech Thorac Cardiovasc Surg doi: 10.1053/j.optechstcvs.2013.03.001 contributor: fullname: Russell – volume: 14 start-page: 60 year: 2004 ident: 10.1016/j.athoracsur.2016.02.044_bib1 article-title: Cardiovascular causes of airway compression publication-title: Pediatr Anesth doi: 10.1046/j.1460-9592.2003.01192.x contributor: fullname: Kaussman |
SSID | ssj0002155 |
Score | 2.3406057 |
Snippet | Background A descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main... A descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main bronchi.... BACKGROUNDA descending thoracic aorta that traverses the midline is an uncommon cause of airway compression affecting the distal trachea and proximal main... |
SourceID | proquest crossref pubmed elsevier |
SourceType | Aggregation Database Index Database Publisher |
StartPage | 859 |
SubjectTerms | Airway Obstruction - diagnostic imaging Airway Obstruction - surgery Aorta, Thoracic - surgery Bronchi - diagnostic imaging Cardiothoracic Surgery Child Child, Preschool Humans Infant Magnetic Resonance Imaging Retrospective Studies Surgery Tomography, X-Ray Computed Trachea - diagnostic imaging |
Title | Descending Aortic Translocation for Relief of Distal Tracheal and Proximal Bronchial Compression |
URI | https://www.clinicalkey.es/playcontent/1-s2.0-S0003497516002289 https://dx.doi.org/10.1016/j.athoracsur.2016.02.044 https://www.ncbi.nlm.nih.gov/pubmed/27209610 https://search.proquest.com/docview/1813901261 |
Volume | 102 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELaWcuGCqHgtj8pIXIPWjuPE4lTYQoUEFxZpbyZObNGqzVYkK6Ge-OnM2M5jRVcqXKLdxImVmS_jGfubMSGveeWUYNwkvE7zRAhjElUJlpS5szWAOpcOpwY-f5Gn38SndbaezX5PWEvbzryprm_MK_kfrcI50Ctmyf6DZoeHwgn4DfqFI2gYjrfS8dLXYvJpKccbvBxqleP4NFAIkXNsHfqES3QVL7BJhe5hnyfw6-wS_kA43iDt-cJbiECObaaeq9-9eai23P0A6FTQYTtJq_bTe2C5r8OaxwkYs3KSaGbbAA9MDxoTIEZGClJtwOwOs9FLTDbChfx3aciP2J618b44TcHkwMOCUSaa1ownGG3t2N4Fn4AsnVjSIjT8y8KHyYZzELR_UXhL5OdJX3g1VJKcKP7q0mse15qVjPTZ3era_aU75C6WUsTdFz6uR5IQOERZ5H8FVuDN3WJJ6figff7NvvjF-zGrB-R-DEDocUDTIZnZ5iH5PiKJBiTRHSRRQBINSKIbRwOSaI8kCkiiPZLogCQ6QdIjsvpwsnp_msS9N5JK5KqDodlZl7O6ylghheHMgate1mltUityGBOlsgtuVWYdlxbiCFFxiI4dc5lUSqSPyUGzaexTQiECB9kYXI_PRFqWBiJklRUVq3IlTWHmhPUC01ehworuqYfnepS3RnnrBdcg7znJe8nqPoMYxjzbxo-z1Uy30FJ_DQWY8oxJX-lJzcnb4c7oYwbfUQPAbtHvq16NGswwrq2Vjd1sob-C4ewhl2xOngT9Dm_TQ-PZ3ivPyb3xm3lBDrqfW_sSnN3OHHk8_gEouaoj |
link.rule.ids | 314,780,784,27924,27925 |
linkProvider | Geneva Foundation for Medical Education and Research |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Descending+Aortic+Translocation+for+Relief+of+Distal+Tracheal+and+Proximal+Bronchial+Compression&rft.jtitle=The+Annals+of+thoracic+surgery&rft.au=McKenzie%2C+E+Dean&rft.au=Roeser%2C+Mark+E&rft.au=Thompson%2C+Jess+L&rft.au=De+Le%C3%B3n%2C+Luis+E&rft.date=2016-09-01&rft.eissn=1552-6259&rft.volume=102&rft.issue=3&rft.spage=859&rft_id=info:doi/10.1016%2Fj.athoracsur.2016.02.044&rft_id=info%3Apmid%2F27209610&rft.externalDocID=27209610 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0003-4975&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0003-4975&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0003-4975&client=summon |