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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/28318515/effect-of-dose-and-timing-of-preoperative-statins-on-mortality-after-coronary-artery-bypass-surgery
#1
Michael Curtis, Yi Deng, Vei-Vei Lee, MacArthur A Elayda, Joseph S Coselli, Charles D Collard, Wei Pan
BACKGROUND: Preoperative statin administration is associated with reduced mortality risk after a coronary artery bypass graft operation. However, the optimal dose and timing are unknown. METHODS: We retrospectively reviewed data from 3,025 primary isolated coronary artery bypass graft surgery patients at our institution. Patients were divided into three groups, according to timing of their preoperative statin: 24 hours or less (n = 1,788), 24 to 72 hours (n = 452), or more than 72 hours before operation or no dose (n = 781)...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28318514/incorporating-comorbidity-within-risk-adjustment-for-uk-pediatric-cardiac-surgery
#2
Katherine L Brown, Libby Rogers, David J Barron, Victor Tsang, David Anderson, Shane Tibby, Thomas Witter, John Stickley, Sonya Crowe, Kate English, Rodney C Franklin, Christina Pagel
BACKGROUND: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28318513/improving-risk-adjustment-for-mortality-after-pediatric-cardiac-surgery-the-uk-prais2-model
#3
Libby Rogers, Katherine L Brown, Rodney C Franklin, Gareth Ambler, David Anderson, David J Barron, Sonya Crowe, Kate English, John Stickley, Shane Tibby, Victor Tsang, Martin Utley, Thomas Witter, Christina Pagel
BACKGROUND: Partial Risk Adjustment in Surgery (PRAiS), a risk model for 30-day mortality after children's heart surgery, has been used by the UK National Congenital Heart Disease Audit to report expected risk-adjusted survival since 2013. This study aimed to improve the model by incorporating additional comorbidity and diagnostic information. METHODS: The model development dataset was all procedures performed between 2009 and 2014 in all UK and Ireland congenital cardiac centers...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28318512/understanding-children-s-heart-surgery-data-a-cross-disciplinary-approach-to-codevelop-a-website
#4
REVIEW
Christina Pagel, Emily Jesper, Joanne Thomas, Emily Blackshaw, Tim Rakow, Mike Pearson, David Spiegelhalter
Risk-adjusted survival statistics after children's heart surgery are published annually in the United Kingdom. Interpreting these statistics is difficult, and better resources about how to interpret survival data are needed. Here we describe how a multidisciplinary team of mathematicians, psychologists, and a charity worked with parents of heart surgery children and other users to codevelop online resources to present survival outcomes. Early and ongoing involvement of users was crucial and considerably changed the content, scope, and look of the website, and the formal psychology experiments provided deeper insight...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274523/intraoperative-stenting-of-pulmonary-artery-stenosis-in-children-with-congenital-heart-disease
#5
Mathilde Meot, Bruno Lefort, Jean Marc El Arid, Nathalie Soulé, Julie Lothion-Boulanger, François Lengellé, Alain Chantepie, Paul Neville
BACKGROUND: Branch pulmonary artery (BPA) stenosis is frequently associated with congenital heart disease. Management of BPA stenosis is challenging for surgeons due to a high rate of recurrence. The purpose of this study was to assess the results of intraoperative pulmonary artery stenting associated with or without surgical angioplasty. METHODS: We included 33 children from our center between January 2008 and July 2014. Patients had pulmonary atresia with ventricular septal defect (13), tetralogy of Fallot (10), troncus arteriosus (4), double outlet right ventricle (2), and single left or right ventricle (4)...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274522/preoperative-glycosylated-hemoglobin-a-risk-factor-for-patients-undergoing-coronary-artery-bypass
#6
Pradeep Narayan, Sarang Naresh Kshirsagar, Chandan Kumar Mandal, Paramita Auddya Ghorai, Yashaskar Manjunatha Rao, Debasis Das, Atanu Saha, Saibal Roy Chowdhury, Emmanuel Rupert, Mrinalendu Das
BACKGROUND: The prevalence of diabetes in the population of patients presenting with coronary artery disease continues to rise. The aim of this study was to assess whether high Glycosylated hemoglobin (HbA1c) was associated with adverse outcomes in patients undergoing elective coronary artery bypass grafting. METHODS: A retrospective observational study on prospectively collected data in 4,678 patients undergoing elective, isolated coronary artery bypass graft procedures in a single institution over a 4-year period was conducted...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274521/cavopulmonary-anastomosis-during-same-hospitalization-as-stage-1-norwood-hybrid-palliative-surgery
#7
Sachin D Tadphale, Xinyu Tang, Nahed O ElHassan, Brandon Beam, Parthak Prodhan
BACKGROUND: Limited literature has examined characteristics of infants with hypoplastic left heart syndrome (HLHS) who remain hospitalized during the interstage period. We described their epidemiologic characteristics, in-hospital outcomes, and identified risk factors that predict the need for superior cavopulmonary anastomosis (SCPA) during the same hospitalization. METHODS: This retrospective multicenter database analysis included infants with HLHS who underwent stage 1 palliation from 2004 through 2013...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274520/the-carotid-artery-as-a-preferred-alternative-access-route-for-transcatheter-aortic-valve-replacement
#8
Eric B Kirker, Robert W Hodson, Kateri J Spinelli, Ethan C Korngold
BACKGROUND: In high-risk patients with severe aortic stenosis, transfemoral (TF) access for transcatheter aortic valve replacement (TAVR) is the preferred access route but is not always feasible. Compared with other alternative access routes, transcarotid (TC) access is often overlooked by many valvular heart teams. METHODS: We report our single-center experience of all patients undergoing TC (n = 25), transapical (TA) (n = 12), or TF (n = 100; limited to most recent cases) TAVR over a 1...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274519/regional-heterogeneity-in-the-mitral-valve%C3%A2-apparatus-in-patients-with-ischemic%C3%A2-mitral-regurgitation
#9
Feroze Mahmood, Ziyad O Knio, Lu Yeh, Rabia Amir, Robina Matyal, Azad Mashari, Robert C Gorman, Joseph H Gorman, Kamal R Khabbaz
BACKGROUND: Apical displacement of the coaptation point of the mitral valve (MV) in response to ischemic mitral regurgitation (IMR) represents remodeling of the MV apparatus. Whereas it implies chronicity, it lacks specificity in discriminating normal from a significantly remodeled MV apparatus. Regional aspects of MV remodeling have shown superior value over global remodeling in predicting recurrence after MV repair for IMR. Quite possibly, presence of specific regional changes in MV geometry that are unique to chronic IMR patients could also be used to diagnose the presence and track progression of remodeling...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274518/replacing-the-anterior-mitral-valve-leaflet-with-autologous-jugular-vein-in-a-sheep-model
#10
Jacques T Janson, Andre Coetzee, Gawie Rossouw, Izak Loftus, Adriaan Murray, Pieter Rossouw, Philip Herbst
BACKGROUND: This study evaluated the use of an autologous vein graft, supported by expanded polytetrafluoroethylene (ePTFE) chordae tendineae, to replace an anterior mitral valve leaflet. METHODS: A double-layered autologous jugular vein graft, supported by ePTFE chords, was used to create an anterior mitral valve leaflet in 21 sheep. Mitral valve function was monitored with echocardiography for up to 10 months. Surviving sheep were euthanized between 6 and 10 months later, and vein implants were examined histologically...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274517/lung-cancer-diagnosis-by-fine-needle-aspiration-is-associated-with-reduction-in-resection-of-nonmalignant-lung-nodules
#11
Julie A Barta, Claudia I Henschke, Raja M Flores, Rowena Yip, David F Yankelevitz, Charles A Powell
BACKGROUND: The rates of resection of nonmalignant lung nodules suspected preoperatively to be lung cancer vary widely and are reported to be as high as 40%. We determined the impact of the frequent use of computed tomography (CT)-guided fine needle aspiration (FNA) on the resection rate of nonmalignant nodules and frequency of resections of benign disease among patients undergoing evaluation for lung cancer resection operation in an academic medical center. METHODS: Eligible patients underwent CT-guided FNA, surgical resection, or both during the 12-month period between July 2013 and July 2014 for known or suspected first primary resectable stage I-III lung cancer...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28274516/the-dynamic-compression-brace-for-pectus-carinatum-intermediate-results-in-286-patients
#12
Sjoerd A de Beer, Martin Gritter, Justin R de Jong, Ernst L W van Heurn
BACKGROUND: Dynamic brace compression is a novel treatment for patients with pectus carinatum. The dynamic compression system contains a device to measure the flexibility of the thoracic wall and regulate the pressure of the brace. METHODS: Patients referred to our pediatric surgical center were screened for treatment with the dynamic compression brace. Patients with a pressure of initial correction (PIC) of 10.0 pounds per square inch or less were offered treatment with the brace...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267981/healthcare-associated-infections-in-cardiac-surgery-patients-with-prolonged-intensive-care-unit-stay
#13
Michael Mazzeffi, James Gammie, Bradley Taylor, Sarah Cardillo, Nicholina Haldane-Lutterodt, Anthony Amoroso, Anthony Harris, Kerri Thom
BACKGROUND: Healthcare-associated infections (HAIs) are responsible for many deaths of hospitalized patients each year. Patients with prolonged hospitalization are at high risk for HAIs. Increased efforts have been made to decrease these infections, but a recent report from the Centers for Disease Control suggests that some HAIs may be increasing. We hypothesized that HAIs would remain frequent among cardiac surgery patients with prolonged intensive care unit stay and would be associated with increased mortality...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267980/postoperative-extracorporeal-membrane-oxygenation-support-for-acute-type-a-aortic-dissection
#14
Ting-Wei Lin, Meng-Ta Tsai, Yu-Ning Hu, Wei-Hung Lin, Wei-Ming Wang, Chwan-Yau Luo, Jun-Neng Roan
BACKGROUND: Few studies have investigated the use of postoperative extracorporeal membrane oxygenation (ECMO) in acute type A aortic dissection (aTAAD). We identified aTAAD surgical patients at risk of ECMO implantation postoperatively and analyzed the prognosis of these patients. METHODS: We retrospectively reviewed 162 consecutive aTAAD patients undergoing operations from January 2008 to December 2015. Patient data were analyzed for risk factors leading to an ECMO requirement...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267979/hiatal-hernia-after-esophagectomy-for-cancer
#15
Hylke J F Brenkman, Kevin Parry, Fergus Noble, Richard van Hillegersberg, Donna Sharland, Lucas Goense, Jamie Kelly, James P Byrne, Timothy J Underwood, Jelle P Ruurda
BACKGROUND: Hiatal hernia (HH) after esophagectomy is becoming more relevant due to improvements in survival. This study evaluated and compared the occurrence and clinical course of HH after open and minimally invasive esophagectomy (MIE). METHODS: The prospectively recorded characteristics of patients treated with esophagectomy for cancer at 2 tertiary referral centers in the United Kingdom and the Netherlands between 2000 and 2014 were reviewed. Computed tomography reports were reviewed to identify HH...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267978/identification-of-essential-components-of-thoracoscopic-lobectomy-and-targets-for%C3%A2-simulation
#16
Mark K Ferguson, Cathy Bennett
BACKGROUND: Fewer than 50% of lobectomies for lung cancer are performed using thoracoscopic (video-assisted thoracic surgery [VATS]) techniques. This situation could be mitigated through the use of simulation training. Using a Delphi process, this study identified essential components of VATS right upper lobectomy most amenable to focused simulation. METHODS: Experienced VATS surgeons were randomly selected for participation. A custom Internet interface permitted anonymous voting, commenting, and the ability to modify and propose new components...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267977/indications-for-adjuvant-mediastinal-radiotherapy-in-surgically-resected-small-cell-lung-cancer
#17
Elliot Wakeam, Meredith Giuliani, Natasha B Leighl, Samuel R G Finlayson, Thomas K Varghese, Gail E Darling
BACKGROUND: Adjuvant mediastinal radiotherapy (AMR) is used after surgical resection for patients with small cell lung cancer (SCLC), but data guiding its use are scant. We sought to examine whether AMR was associated with an improvement in survival for resected SCLC patients and to define subpopulations who should be selected for AMR. METHODS: Patients undergoing lobectomy, pneumonectomy, and sublobar resection for SCLC were identified in the National Cancer Database (2004 to 2013)...
March 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28262301/effects-of-alcohol-on-postoperative-adhesion-formation-in-ischemic-myocardium-and-pericardium
#18
Nassrene Y Elmadhun, Ashraf A Sabe, Antonio D Lassaletta, Rahul S Dalal, Frank W Sellke
BACKGROUND: Postoperative formation of adhesions increases risk of complications during cardiac reoperations. We previously demonstrated that swine supplemented with vodka had a significant reduction in adhesions at sternotomy after previous thoracotomy. This follow-up study was conducted to determine reproducibility and the mechanism for adhesion reduction in swine supplemented with ethanol. METHODS: An ameroid constrictor was placed in the left circumflex in 14 male Yorkshire swine to induce chronic myocardial ischemia through left minithoracotomy...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28262300/invasive-mediastinal-staging-guideline%C3%A2-concordance
#19
Anna Bendzsak, Thomas K Waddell, Kazuhiro Yasufuku, Shaf Keshavjee, Marc de Perrot, Marcelo Cypel, Andrew F Pierre, Gail E Darling
BACKGROUND: Despite guidelines for preoperative invasive mediastinal staging (IMS) for non-small cell lung cancer (NSCLC), concordance with guidelines and whether the use of these guidelines results in expected frequency of lymph node metastases has not been evaluated. Our objectives were to determine guideline concordance, reasons for nonconcordance, and, in patients who did not receive IMS, to determine the use of operative nodal sampling and final pathologic staging. METHODS: Patients who had a resection for NSCLC between 2010 and 2012 were identified from the Institutional Cancer Registry...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28262299/high-risk-for-thoracotomy-but-not-thoracoscopic-lobectomy
#20
Laura L Donahoe, Moira de Valence, Eshetu G Atenafu, Waël C Hanna, Thomas K Waddell, Andrew F Pierre, Kazuhiro Yasufuku, Marc de Perrot, Marcelo Cypel, Shaf Keshavjee, Gail E Darling
BACKGROUND: Pulmonary lobectomy is the standard of care for resection of non-small cell lung cancer (NSCLC). Patients with compromised lung function who are considered high risk may be denied surgical treatment; thus, proper identification of those truly at high risk is critical. Video-assisted thoracic surgery (VATS) may reduce the operative risk. This study reviews our institutional experience of pulmonary lobectomy by open thoracotomy or VATS techniques in patients deemed to be high risk...
March 2, 2017: Annals of Thoracic Surgery
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