The Annals of thoracic surgery
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Multicenter Study
Seminal Postoperative Complications and Mode of Death After Pediatric Cardiac Surgical Procedures.
Understanding the seminal complications leading to death after pediatric cardiac surgical procedures may provide opportunities to reduce mortality. This study analyzed all deaths at two pediatric cardiac surgical programs and developed a method to identify the seminal complications and modes of death. ⋯ Seminal complications occurred early postoperatively, and systemic circulatory failure was the most common mode of death. Our classification system is likely scalable for subsequent multicenter analysis to understand cause-specific mortality variation across hospitals and to drive quality improvement.
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There is only limited information on the clinical impact of combined pulmonary fibrosis and emphysema (CPFE) on postoperative and survival outcomes among patients with resected lung cancer. ⋯ Among patients with resected lung cancer, the presence of TSCT-determined CPFE might predict worse postoperative and survival outcomes.
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Heparin is the main anticoagulant used during extracorporeal membrane oxygenation (ECMO) support. Nafamostat mesilate, a synthetic serine protease inhibitor, has seen increased use as a substitute for heparin in patients undergoing ECMO because of its short half-life. We aimed to compare these 2 anticoagulants with respect to bleeding and thromboembolic complications during ECMO support. ⋯ Nafamostat mesilate was found to increase the bleeding risk in patients receiving venoarterial ECMO. Regarding thromboembolic complications, there was no significant difference between heparin and nafamostat. Only old age increased the thromboembolic risk.
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Multicenter Study
Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis.
The objective of this study was to evaluate outcomes of minimally invasive approaches to esophagectomy using population-level data. ⋯ The use of minimally invasive techniques to perform esophagectomy for esophageal cancer is associated with modestly improved perioperative outcomes without compromising survival.
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Multicenter Study Observational Study
Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Severe Aortic Stenosis in Patients With Chronic Kidney Disease Stages 3b to 5.
There are scarce data on outcomes after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in patients with renal failure. ⋯ CKD stages 3b to 5 increases the risk of mortality after TAVI and SAVR. In this subset of patients, SAVR was associated with somewhat better early and late survival. The risk of acute kidney injury was higher after SAVR. These findings suggest that CKD stages 3b to 5 does not contraindicate SAVR. Strategies to prevent severe acute kidney injury should be implemented with either SAVR or TAVI.