Browse Health
Surgical Specialist, Cardiothoracic Surgeon
18 years of experience
Accepting new patients

Education ?

Medical School Score Rankings
Harvard University (1992)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
Recognized in Philadelphia Magazine's 2011 and 2012 Top Docs issues
Castle Connolly America's Top Doctors® (2009, 2013 - 2014)
Patients' Choice Award (2012)
Associations
American Board of Surgery
American Board of Thoracic Surgery
Cardiothoracic Surgery Network
Society of Thoracic Surgeons

Affiliations ?

Dr. Pechet is affiliated with 14 hospitals.

Hospital Affilations

Score

Rankings

  • University of PA Medical Center/Presbyterian
    Thoracic Surgery (Cardiothoracic Vascular Surgery)
    51 N 39th St, Philadelphia, PA 19104
    • Currently 4 of 4 crosses
    Top 25%
  • Hospital of the University of PA
    Thoracic Surgery (Cardiothoracic Vascular Surgery)
    3400 Spruce St, Philadelphia, PA 19104
    • Currently 3 of 4 crosses
    Top 50%
  • Pennsylvania Hospital University PA Health System
    Thoracic Surgery (Cardiothoracic Vascular Surgery)
    800 Spruce St, Philadelphia, PA 19107
    • Currently 3 of 4 crosses
    Top 50%
  • Methodist Hospital
    2301 S Broad St, Philadelphia, PA 19148
    • Currently 3 of 4 crosses
    Top 50%
  • Graduate Hospital
    1800 Lombard St, Philadelphia, PA 19146
    • Currently 1 of 4 crosses
  • Thomas Jefferson University Hospital
    Thoracic Surgery (Cardiothoracic Vascular Surgery)
    111 S 11th St, Philadelphia, PA 19107
    • Currently 1 of 4 crosses
  • Clinical Practices of the University of Pennsylvania
  • Philadelphia Veterans Affairs Medical Center
    3900 Woodland Ave, Philadelphia, PA 19104
  • Uphs Hosptial Of The University Of Penns
  • Clinical Health Care Associates of New Jersey
  • Pennsylvania Hospital
  • University of Penn Med Center-Presb Med Group
  • Penn Presbyterian Medical Center - UPHS *
  • Presbyterian Medical Center
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Pechet has contributed to 9 publications.
    Title Management of an Anterior Mediastinal Pheochromocytoma Causing Tracheomalacia.
    Date December 2007
    Journal The Annals of Thoracic Surgery
    Excerpt

    Thoracic paragangliomas are rare tumors that arise from extra-adrenal chromaffin cells and have the capacity to secrete catecholamines. Surgical excision is the optimal treatment of these tumors as they are resistant to chemotherapy and radiation therapy. Although these tumors are most commonly found in the abdomen, 10% of paraganagliomas are located in the thorax, usually in the posterior mediastinum. Occasionally these tumors present in the anterior mediastinum, which can pose a significant surgical challenge due to the proximity of the great vessels and airway. In this report we describe the treatment of an anterior mediastinal pheochromocytoma that presented with tracheal obstruction and required pulmonary artery reconstruction and airway stenting.

    Title Morbidity and Mortality of Major Pulmonary Resections in Patients with Early-stage Lung Cancer: Initial Results of the Randomized, Prospective Acosog Z0030 Trial.
    Date September 2006
    Journal The Annals of Thoracic Surgery
    Excerpt

    BACKGROUND: Little prospective, multiinstitutional data exist regarding the morbidity and mortality after major pulmonary resections for lung cancer or whether a mediastinal lymph node dissection increases morbidity and mortality. METHODS: Prospectively collected 30-day postoperative data was analyzed from 1,111 patients undergoing pulmonary resection who were enrolled from July 1999 to February 2004 in a randomized trial comparing lymph node sampling versus mediastinal lymph node dissection for early stage lung cancer. RESULTS: Of the 1,111 patients randomized, 1,023 were included in the analysis. Median age was 68 years (range, 23 to 89 years); 52% were men. Lobectomy was performed in 766 (75%) and pneumonectomy in 42 (4%). Pathologic stage was IA in 424 (42%), IB in 418 (41%), IIA in 37 (4%), IIB in 97 (9%), and III in 45 (5%). Lymph node sampling was performed in 498 patients and lymph node dissection in 525. Operative mortality was 2.0% (10 of 498) for lymph node sampling and 0.76% (4 of 525) for lymph node dissection. Complications occurred in 38% of patients in each group. Lymph node dissection had a longer median operative time and greater total chest tube drainage (15 minutes, 121 mL, respectively). There was no difference in the median hospitalization, which was 6 days in each group (p = 0.404). CONCLUSIONS: Complete mediastinal lymphadenectomy adds little morbidity to a pulmonary resection for lung cancer. These data from a current, multiinstitutional cohort of patients who underwent a major pulmonary resection constitute a new baseline with which to compare results in the future.

    Title Arterial Invasion Predicts Early Mortality in Stage I Non-small Cell Lung Cancer.
    Date February 2005
    Journal The Annals of Thoracic Surgery
    Excerpt

    BACKGROUND: A retrospective study was performed to evaluate the association between arterial invasion and survival in patients with stage I non-small cell lung cancer. METHODS: One hundred patients were identified who had undergone complete anatomic resection as definitive treatment for stage I non-small cell lung cancer. The tumors were reviewed for the presence or absence of arterial invasion. Five-year survival data were obtained for all patients. RESULTS: The 100 patients had an overall 5-year survival of 61%. There were 64 stage IA patients with a 62% 5-year survival and 36 stage IB patients with a 58% 5-year survival. The 39 patients identified with arterial invasion had a 38% 5-year survival compared with a 73% 5-year survival in the 61 patients without arterial invasion (p < 0.001), with an unadjusted hazard ratio of 3.5 (p < 0.001). Multivariate analysis by stage IA versus IB and by size greater or less than 2 cm demonstrated hazard ratios of 3.5 and 4.0, respectively (p < 0.001). This difference was independent of demographic characteristics, tumor type, or grade. Subgroup analysis revealed a hazard ratio of 5.8 in patients with stage IA non-small cell lung cancer (p < 0.001) and 19.8 in patients with tumors < or = 2 cm (p = 0.006). CONCLUSIONS: Arterial invasion is present in a substantial percentage of patients with stage I non-small cell lung cancer and is adversely associated with survival.

    Title Pleurectomy and Decortication for Malignant Mesothelioma.
    Date December 2004
    Journal Thoracic Surgery Clinics
    Excerpt

    P/D in combination with other therapies remains an effective weapon in the thoracic surgeon's armamentarium for treating patients with MPM, particularly patients with limited lung function. A clear benefit has been demonstrated in terms of symptom relief. Further strategies aimed at eliminating residual disease in an effort to prevent locoregional recurrence and as potential curative therapies currently are being investigated.

    Title Lung Transplantation for Lymphangioleiomyomatosis.
    Date June 2004
    Journal The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
    Excerpt

    BACKGROUND: Lymphangioleiomyomatosis is a rare disease in women leading to respiratory failure. We describe a single-institution experience with lung transplantation for end-stage lymphangioleiomyomatosis. METHODS: We retrospectively reviewed records of patients transplanted for lymphangioleiomyomatosis between 1989 and 2001. Follow-up was complete on all patients (median 3.5 years). RESULTS: Seven single and 7 bilateral transplants were performed on 14 recipients (mean age 41.8 years). Eleven patients suffered the following intra-operative complications: dysrhythmia (1); blood loss > 1,000 ml (7); extensive pleural adhesions (10); hypothermia (1); phrenic nerve injury (1); and graft dysfunction (2). The following post-operative complications occurred in 11 recipients: dysrhythmia (7); respiratory failure (5); sepsis (3); airway dehiscence (2); vocal cord dysfunction (1); cholecystitis (1); deep vein thrombosis (1); acute renal failure (1); and pericarditis (1). Post-operative chylous fistulas necessitated thoracic duct ligation (1); sclerosis (6); and drainage of ascites (1). There were no peri-operative deaths. Late deaths occurred due to sepsis in 2 patients and obliterative bronchiolitis in 1 patient. Survival rates were 100%, 90% and 69% at (1, 2 and 5 years, respectively.) Mean FEV1 (1.77 +/- 1.06 vs 0.60 +/- 0.91) and 6-minute walk (1,519 +/- 379 vs 826 +/- 293 feet) improved at 1 year as compared with pre-transplant evaluation. Five patients reached criteria for bronchiolitis obliterans syndrome. One recipient has had a documented recurrence of lymphangioleiomyomatosis in the transplanted lung. CONCLUSIONS: Early and late survival after lung transplant are comparable in lymphangioleiomyomatosis patients versus patients with other diseases. Morbidity is common after transplant for lymphangioleiomyomatosis and is usually due to lymphangioleiomyomatosis-related complications. Lymphangioleiomyomatosis recurrence in the allograft does not pose a substantial clinical problem.

    Title Intestinal Reperfusion Injury is Mediated by Igm and Complement.
    Date May 1999
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    Intestinal ischemia-reperfusion injury is dependent on complement. This study examines the role of the alternative and classic pathways of complement and IgM in a murine model of intestinal ischemia-reperfusion. Wild-type animals, mice deficient in complement factor 4 (C4), C3, or Ig, or wild-type mice treated with soluble complement receptor 1 were subjected to 40 min of jejunal ischemia and 3 h of reperfusion. Compared with wild types, knockout and treated mice had significantly reduced intestinal injury, indicated by lowered permeability to radiolabeled albumin. When animals deficient in Ig were reconstituted with IgM, the degree of injury was restored to wild-type levels. Immunohistological staining of intestine for C3 and IgM showed colocalization in the mucosa of wild-type controls and minimal staining for both in the intestine of Ig-deficient and C4-deficient mice. We conclude that intestinal ischemia-reperfusion injury is dependent on the classic complement pathway and IgM.

    Title Alpha 1-acid Glycoprotein Reduces Local and Remote Injuries After Intestinal Ischemia in the Rat.
    Date December 1997
    Journal The American Journal of Physiology
    Excerpt

    The aim of this study was to look at the role of alpha 1-acid glycoprotein as a natural anti-inflammatory agent with particular respect to its antineutrophil and anticomplement activity. A recombinantly engineered form of sialyl Lewisx (sLe(x))-bearing alpha 1-acid glycoprotein (sAGP) was administered intravenously to pentobarbital-anesthetized rats after 50 min of intestinal ischemia just before 4 h of reperfusion. A non-sLe(x)-bearing form of AGP (nsAGP) was used as control. sAGP-treated animals had a 62% reduction (P < 0.05) in remote lung injury, assessed by 125I-albumin permeability, compared with those treated with nsAGP (permeability index of 3.61 +/- 0.15 x 10(-3) and 5.18 +/- 0.67 x 10(-3), respectively). There was a reduction in pulmonary myeloperoxidase levels in sAGP-treated rats compared with nsAGP-treated rats. Complement-dependent intestinal injury, assessed by 125I-albumin permeability was reduced by 28% (P < 0.05) in animals treated with sAGP (7.58 +/- 0.63) compared with those treated with nsAGP (10.4 +/- 0.54). We conclude that sAGP ameliorates both complement- and neutrophil-mediated injuries.

    Title Experimental Murine Acid Aspiration Injury is Mediated by Neutrophils and the Alternative Complement Pathway.
    Date November 1997
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    Acid aspiration may result in the development of the acute respiratory distress syndrome, an event associated with significant morbidity and mortality. Although once attributed to direct distal airway injury, the pulmonary failure after acid aspiration is more complex and involves an inflammatory injury mediated by complement (C) and polymorphonuclear leukocytes. This study examines the injurious inflammatory cascades that are activated after acid aspiration. The role of neutrophils was defined by immunodepletion before aspiration, which reduced injury by 59%. The injury was not modified in either P- or E-selectin-knockout mice, indicating that these adhesion molecules were not operative. C activation after aspiration was documented with immunochemistry by C3 deposition on injured alveolar pneumocytes. Animals in which C activation was inhibited with soluble C receptor type 1 (sCR1) had a 54% reduction in injury, similar to the level of protection seen in C3-knockout mice (58%). However C4-knockout mice were not protected from injury, indicating that C activation is mediated by the alternative pathway. Finally, an additive effect of neutrophils and C was demonstrated whereby neutropenic animals that were treated with sCR1 showed an 85% reduction in injury. Thus acid aspiration injury is mediated by neutrophils and the alternative C pathway.

    Title Lung Transplantation for Lymphangioleiomyomatosis.
    Date
    Journal The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation

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