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https://www.readbyqxmd.com/read/29427617/single-versus-multi-center-surgeons-risk-adjusted-coronary-artery-bypass-graft-procedural-outcomes
#1
A Laurie W Shroyer, William E Gioia, Muath Bishawi, Amelia S Wallace, Brian C Gulack, Ying Xian, Sean M O'Brien, Vinod H Thourani, Thomas V Bilfinger
BACKGROUND: Since 2010, 460+ hospital mergers have occurred in the United States rerouting historical coronary artery bypass graft [CABG] referral patterns. The goals of this study were: 1) to compare risk-adjusted CABG outcomes between single-center versus multi-center surgeons; and 2) for multi-center surgeons, to evaluate the risk-adjusted outcomes between their home (primary) versus satellite (secondary) hospitals. METHODS: Using the Society of Thoracic Surgeons Adult Cardiac Surgery Database, non-emergent, first-time CABG procedures (n = 543,403) performed in the United States between 2011 and 2014 were extracted across 1,120 centers and for 2,676 surgeons...
February 7, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29413254/mitral-bioprosthetic-valve-fracture-bailout-procedure-for-undersized-bioprosthesis-during-mitral%C3%A2-valve-in-valve-procedure-with-paravalvular-leak-closure
#2
Norihiko Kamioka, Frank Corrigan, Jose Miguel Iturbe, Hope Caughron, Stamatios Lerakis, Vinod Thourani, Peter Block, Robert Guyton, Vasilis Babaliaros
No abstract text is available yet for this article.
February 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29391145/associations-between-surgical-ablation-and-operative-mortality-following-mitral-valve-procedures
#3
J Scott Rankin, Maria V Grau-Sepulveda, Niv Ad, Ralph J Damiano, A Marc Gillinov, J Matthew Brennan, Patrick M McCarthy, Vinod H Thourani, Jeffrey P Jacobs, David M Shahian, Vinay Badhwar
BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) concomitant to mitral valve repair/replacement (MVRR) improves longitudinal sinus rhythm. However, the risk of adding SA remains a clinical question. This study examined whether the addition of contemporary SA for AF has an impact on operative outcomes. METHODS: The study cohort included 88,765 MVRR patients ± SA, CABG, septal defect, and tricuspid repair in the STS Database between 2011 and 2014. Group 1 did not have AF (No-AF) and did not receive SA (No-SA); Group 2 had No-AF immediately preoperatively but received SA; Group 3 had AF but No-SA; and Group 4 had AF with SA...
January 29, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29374578/mean-aortic-pressure-gradient-and-global-longitudinal-strain-recovery-after-transcatheter-aortic-valve-replacement-a-retrospective-analysis
#4
Frank E Corrigan, Xiao Zhou, John C Lisko, Salim S Hayek, Ioannis Parastatidis, Patricia Keegan, Sharon Howell, Vinod Thourani, Vasilis C Babaliaros, Stamatios Lerakis
BACKGROUND: Global longitudinal strain (GLS) has incremental value in assessing left ventricular (LV) function in severe aortic stenosis and is related to clinical outcome after transcatheter aortic valve replacement (TAVR). We sought to identify relevant echocardiographic predictors of GLS improvement and myocardial function recovery after TAVR. METHODS: We analyzed baseline and 12-month follow-up echocardiograms for LV strain analysis from 123 patients who underwent at Emory University Hospital with the Edwards SAPIEN valve between 7/2007 and 7/2013...
January 25, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29348004/predictors-and-clinical-outcomes-of-next-day-discharge-after-minimalist-transfemoral-transcatheter-aortic-valve%C3%A2-replacement
#5
Norihiko Kamioka, John Wells, Patricia Keegan, Stamatios Lerakis, Jose Binongo, Frank Corrigan, Jose Condado, Ateet Patel, Jessica Forcillo, Leslie Ogburn, Andy Dong, Hope Caughron, Amy Simone, Bradley Leshnower, Chandan Devireddy, Kreton Mavromatis, Robert Guyton, James Stewart, Vinod Thourani, Peter C Block, Vasilis Babaliaros
OBJECTIVES: This study sought to investigate predictors and safety of next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Information about predictors and safety of NDD after TAVR is limited. METHODS: The study reviewed 663 consecutive patients who underwent elective balloon-expandable TAVR (from July 2014 to July 2016) at our institution. We first determined predictors of NDD in patients who underwent minimalist transfemoral TAVR...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29337126/rigid-plate-fixation-vs-wire-cerclage-patient-reported-and-economic-outcomes-from-a-randomized-trial
#6
Keith B Allen, Vinod H Thourani, Yoshifumi Naka, Kendra J Grubb, John Grehan, Nirav Patel, T Sloane Guy, Kevin Landolfo, Marc Gerdisch, Mark Bonnell, David J Cohen
BACKGROUND: In a multicenter randomized trial, sternal closure following cardiac surgery using rigid plate fixation (RPF) compared with wire cerclage (WC) resulted in improved sternal healing, reduced sternal complications and was cost neutral at 6 months. Additional secondary endpoints are presented from this trial. METHODS: Twelve US centers randomized 236 patients to RPF (n=116) or WC (n=120). Patient reported outcomes measures (PROMs) including pain, function, and quality-of-life (QOL) scores were assessed through 6-months and correlated to computed tomographic derived sternal healing scores using logistic regression...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29326112/epidemiology-of-new-onset-atrial-fibrillation-following-coronary-artery-bypass-graft-surgery
#7
Giovanni Filardo, Ralph J Damiano, Gorav Ailawadi, Vinod H Thourani, Benjamin D Pollock, Danielle M Sass, Teresa K Phan, Hoa Nguyen, Briget da Graca
OBJECTIVES: Postoperative atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is significantly associated with reduced survival, but poor characterisation and inconsistent definitions present barriers to developing effective prophylaxis and management. We sought to address this knowledge gap. METHODS: From 2002 to 2010, 11 239 consecutive patients without AF underwent isolated CABG at five sites. Clinical data collected for the Society of Thoracic Surgeons (STS) Database were augmented with details on AF detected via continuous in-hospital ECG/telemetry monitoring to assess new-onset post-CABG AF (adjusted for STS risk of mortality); time to first AF; durations of first and longest AF episodes; total in-hospital time in AF; number of in-hospital AF episodes; operative mortality; stroke; discharge in AF; and length of stay (LOS)...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29314257/contemporary-management-and-outcomes-of-acute-type-a-aortic-dissection-an-analysis-of-the-sts-adult-cardiac-surgery-database
#8
Teng C Lee, Zachary Kon, Faisal H Cheema, Maria V Grau-Sepulveda, Brian Englum, Sunghee Kim, Paramita S Chaudhuri, Vinod H Thourani, Gorav Ailawadi, G Chad Hughes, Matthew L Williams, J Matthew Brennan, Lars Svensson, James S Gammie
PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. RESULTS: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension...
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29301644/sex-specific-outcomes-of-transcatheter%C3%A2-aortic-valve-replacement-with-the-sapien-3-valve-insights-from-the-partner-ii-s3-high-risk-and-intermediate-risk-cohorts
#9
Molly Szerlip, Sarah Gualano, Elizabeth Holper, John J Squiers, Jonathon M White, Darshan Doshi, Mathew R Williams, Rebecca T Hahn, John G Webb, Lars G Svensson, Ajay J Kirtane, David J Cohen, Pamela S Douglas, Maria C Alu, Aaron Crowley, E Murat Tuzcu, Raj R Makkar, Howard C Herrmann, Vasilis Babaliaros, Vinod H Thourani, Martin B Leon, Susheel K Kodali, Michael J Mack
OBJECTIVES: The purpose of this study was to identify sex-specific outcomes of intermediate risk patients undergoing transcatheter aortic valve replacement with the SAPIEN 3 valve. BACKGROUND: A survival difference has been observed in women as compared with men in inoperable and high-risk patients receiving early-generation balloon-expandable valves for transcatheter aortic valve replacement (TAVR). Whether a sex-specific outcome difference persists with newer-generation valves and in lower-risk patients is unknown...
January 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29224637/valve-hemodynamic-deterioration-and-cardiovascular-outcomes-in-tavr-a-report-from-the-sts-acc-tvt-registry
#11
MULTICENTER STUDY
Sreekanth Vemulapalli, David R Holmes, David Dai, Roland Matsouaka, Michael J Mack, Fred L Grover, Raj R Makkar, Vinod H Thourani, Pamela S Douglas
BACKGROUND: Recent reports of leaflet abnormalities (detected using advanced imaging) have raised questions regarding transcatheter aortic valve replacement (TAVR) durability. We sought to determine the incidence of valve hemodynamic deterioration (VHD) and its association with cardiovascular outcomes. METHODS AND RESULTS: Consecutive cases with paired postimplant and follow-up echocardiograms from November 2011 to March 2015 in the STS/ACC TVT Registry were allocated into 2 overlapping cohorts: early (paired echocardiograms at 0 and 30 days) and late (paired echocardiograms at 30 days and 1 year)...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29221750/secondary-surgical-site-infection-after-coronary-artery-bypass-grafting-a-multi-institutional-prospective-cohort-study
#12
Brian C Gulack, Katherine A Kirkwood, Wei Shi, Peter K Smith, John H Alexander, Sandra G Burks, Annetine C Gelijns, Vinod H Thourani, Daniel Bell, Ann Greenberg, Seth D Goldfarb, Mary Lou Mayer, Michael E Bowdish
OBJECTIVE: To analyze patient risk factors and processes of care associated with secondary surgical-site infection (SSI) after coronary artery bypass grafting (CABG). METHODS: Data were collected prospectively between February and October 2010 for consenting adult patients undergoing CABG with saphenous vein graft (SVG) conduits. Patients who developed a deep or superficial SSI of the leg or groin within 65 days of CABG were compared with those who did not develop a secondary SSI...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29217004/transapical-transcatheter-aortic-valve-replacement-is-associated-with-increased-cardiac-mortality-in-patients-with-left%C3%A2-ventricular-dysfunction-insights-from-the-partner-i-trial
#13
Sammy Elmariah, William F Fearon, Ignacio Inglessis, Gus J Vlahakes, Brian R Lindman, Maria C Alu, Aaron Crowley, Susheel Kodali, Martin B Leon, Lars Svensson, Philippe Pibarot, Rebecca T Hahn, Vinod H Thourani, Igor F Palacios, D Craig Miller, Pamela S Douglas, Jonathan J Passeri
OBJECTIVES: The authors sought to evaluate the impact of transapical (TA) transcatheter aortic valve replacement (TAVR) on mortality, left ventricular (LV) ejection fraction (LVEF) improvement, and functional recovery in patients with LV dysfunction. BACKGROUND: LV injury inherent to TA access for structural heart disease interventions may be particularly detrimental to the LV, functional recovery, and survival in patients with LV dysfunction. METHODS: The study included patients enrolled within the PARTNER I (Placement of Aortic Transcatheter Valves) trial that underwent transfemoral (TF) or TA TAVR...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29198795/is-there-still-a-role-for-balloon-dilatation-before-transcatheter-aortic-valve-replacement-or-indeed-for-transaortic-access
#14
EDITORIAL
Toby Rogers, Vinod H Thourani
No abstract text is available yet for this article.
November 7, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29195570/worldwide-trends-in-multi-arterial-coronary-artery-bypass-grafting-surgery-2004-2014-a-tale-of-2-continents
#15
MULTICENTER STUDY
Thomas A Schwann, James Tatoulis, John Puskas, Mark Bonnell, David Taggart, Paul Kurlansky, Jeffery P Jacobs, Vinod H Thourani, Sean O'Brien, Amelia Wallace, Milo C Engoren, Robert F Tranbaugh, Robert H Habib
Recent evidence shows that multi-arterial coronary artery bypass grafting (MABG) based on bilateral internal thoracic (BITA) or left internal thoracic (LITA) and radial artery (RA) improves long-term outcomes compared with single arterial coronary artery bypass grafting (SABG) (LITA + saphenous vein graft). How this evidence affected the worldwide use of MABG, if at all, is not well defined. Accordingly, we report 10-year temporal trends of MABG utilization from 2 continents. A study population of 1,683,434 non-emergent, primary, isolated LITA-based coronary artery bypass grafting (CABG) (≥2 grafts) patients was derived from the Society of Thoracic Surgeons (STS) (1,307,528 (79...
2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29153787/the-society-of-thoracic-surgeons-national-database-2017-annual-report
#16
Jeffrey P Jacobs, David M Shahian, Richard S D'Agostino, Marshall L Jacobs, Benjamin D Kozower, Vinay Badhwar, Vinod H Thourani, Henning A Gaissert, Felix G Fernandez, Richard L Prager
The Society of Thoracic Surgeons (STS) National Database has three major component databases: the STS Adult Cardiac Surgery Database (ACSD), the STS Congenital Heart Surgery Database (CHSD), and the STS General Thoracic Surgery Database (GTSD). Beginning in January 2016, The Annals of Thoracic Surgery began publishing a monthly series of scholarly articles on outcomes analysis, quality improvement, and patient safety. This article summarizes the status of the STS National Database as of October 2017 and summarizes the articles about the STS National Database that appeared in The Annals of Thoracic Surgery 2017 series "Outcomes Analysis, Quality Improvement, and Patient Safety...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29138245/clinical-impact-of-diabetes-mellitus-on-outcomes-after-transcatheter-aortic-valve-replacement-insights-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#17
Yigal Abramowitz, Sreekanth Vemulapalli, Tarun Chakravarty, Zhuokai Li, Samir Kapadia, David Holmes, Roland A Matsouaka, Alice Wang, Wen Cheng, James S Forrester, Richard Smalling, Vinod Thourani, Michael Mack, Martin Leon, Raj R Makkar
BACKGROUND: Diabetes mellitus (DM) adversely affects morbidity and mortality for cardiovascular diseases and procedures. Data evaluating the outcomes of transcatheter aortic valve replacement (TAVR) in diabetic patients are limited by small sample size and contradictory results. We aimed to establish the magnitude of risk and the incremental influence of insulin dependency by examining short- and long-term adverse outcomes according to DM status and therapy in the world's largest TAVR registry...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29132888/the-cardiothoracic-surgical-trials-network-implications-for-clinical-practice
#18
EDITORIAL
Patrick T O'Gara, Thoralf M Sundt, Michael A Acker, Tirone E David, Robert E Michler, Michael A Borger, Gorav Ailawadi, Vinod H Thourani, A Marc Gillinov, Ralph J Damiano, Michael J Mack, Richard Lee, Eric A Rose, Timothy J Gardner, Marissa A Miller, Richard D Weisel, Annetine C Gelijns
No abstract text is available yet for this article.
December 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29126549/predicting-new-onset-post-coronary-artery-bypass-graft-atrial-fibrillation-with-existing-risk-scores
#19
MULTICENTER STUDY
Benjamin D Pollock, Giovanni Filardo, Briget da Graca, Teresa K Phan, Gorav Ailawadi, Vinod Thourani, Ralph J Damiano, James R Edgerton
BACKGROUND: New-onset atrial fibrillation (AF) after coronary artery bypass graft (CABG) operation is associated with poorer survival. Blanket prophylaxis efforts have not appreciably decreased incidence, making targeted prevention for high-risk patients desirable. We compared predictive abilities of existing scores developed/used to predict adverse CABG outcomes (Society of Thoracic Surgeons' [STS] risk of mortality) or AF not associated with cardiac operation (the Cohorts for Heart and Aging Research in Genomic Epidemiology [CHARGE]-AF score, the CHA2DS2-VASc score), and a risk model for predicting postoperative AF following cardiac operations (POAF score), with age (the most consistently identified post-CABG AF risk factor)...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29102215/transcatheter-aortic-valve-replacement-after-mitral-valve-surgery-synergistic-or-incompatible
#20
EDITORIAL
Toby Rogers, Vinod H Thourani
No abstract text is available yet for this article.
September 22, 2017: Journal of Thoracic and Cardiovascular Surgery
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