The Annals of thoracic surgery
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Multicenter Study
Red blood cells and mortality after coronary artery bypass graft surgery: an analysis of 672 operative deaths.
Prior studies have implicated transfusion as a risk factor for mortality in coronary artery bypass graft surgery (CABG). To further our understanding of the true association between transfusion and outcome, we specifically analyzed the subgroup of patients who died after undergoing CABG. ⋯ Significant differences in PROM and the postoperative course leading to death between those with and without transfusion suggest the role of transfusion may be secondary to other patient-related factors. Recognizing that the relationship between transfusion and outcome after CABG remains incompletely understood, these findings are suggestive of a complex interaction of many variables.
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Comparative Study
Comparison of 30-Day Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Replacement: A Single-Center US Experience.
The optimal access route for transcatheter aortic valve replacement (TAVR) remains debatable. We compared early safety outcomes at 30 days between the transfemoral (TF) and transapical (TA) approaches in a single, high-volume center in the United States. ⋯ The TA approach has similar early safety outcomes when compared with the TF approach. The TA approach is more procedurally efficient when compared with the TF approach.
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Hypoplastic left heart syndrome (HLHS) is not only a devastating disease, but also the most expensive birth defect managed in the US. Nosocomial bloodstream infections (NBIs) are common in neonates with HLHS. We examined the effects of NBIs on in-hospital mortality, length of stay, and costs for late preterm and term infants with HLHS undergoing stage 1 palliation, at both individual patient and hospital levels. ⋯ Nosocomial bloodstream infections in neonates with HLHS are associated with large increases in lengths of stay and costs on a patient level, but not a hospital level. For hospitals without particularly high incidences, studies are needed to identify additional targets for quality improvement.
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Data on outcomes of atrioventricular (AV) valve surgical procedures in patients with Fontan circulation are limited. ⋯ The AV valve operation done before, during, or after the Fontan operation is associated with low operative mortality but a high reoperation rate with significant risk of late death, transplantation, and persistent AV valve regurgitation.