The Annals of thoracic surgery
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Multicenter Study
Sexual Harassment and Cardiothoracic Surgery: #UsToo?
Fifty-eight percent of women in science, engineering, and medicine report being affected by sexual harassment (SH). This study sought to determine the extent of SH in cardiothoracic surgery. ⋯ SH is present in cardiothoracic surgery among faculty and trainees. Although women surgeons are more commonly affected, male surgeons also are subjected to SH. Despite witnessed events, intervention currently is limited. Policies, safeguards, and bystander training should be instituted to decrease these events.
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Review Meta Analysis
CHA2DS2-VASc Score for Identifying Patients at High Risk of Postoperative Atrial Fibrillation After Cardiac Surgery: A Meta-analysis.
Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, resulting in an increased risk of morbidity and longer hospital stay. Pharmacologic prophylaxis has been recommended to improve the outcome in patients at high risk of developing POAF after cardiac surgery. Several studies have applied the CHA2DS2-VASc (Congestive heart failure, Hypertension Age [≥65 = 1 point, ≥75 = 2 points], Diabetes, and Stroke/transient ischemic attack (2 points)-vascular disease [peripheral arterial disease, previous myocardial infarction, aortic atheroma]) score in the risk stratification of POAF but yielded contradicting results. This study aims to determine the association between CHA2DS2-VASc score and POAF and further to explore its discriminative ability for the prediction of POAF. ⋯ The CHA2DS2-VASc score has relatively good performance in predicting POAF after cardiac surgery and may help identify the patients at high risk of POAF.
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Multicenter Study
Risk Analysis and Outcomes of Postoperative Renal Failure After Aortic Valve Surgery in the United States.
Postoperative renal failure (RF) compromises early outcomes in cardiac surgery. In contrast, long-term survival and progression of RF after aortic valve replacement (AVR) with or without coronary artery bypass graft surgery (CABG) remain undefined. ⋯ Postoperative RF after AVR with or without CABG was associated with higher early and late mortality, which further increased with a new requirement for dialysis. Once postoperative RF develops, preoperative renal dysfunction does not increase early mortality; however, it predicts late survival. Preoperative renal function is associated with progression of postoperative RF to dialysis.
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This study sought to evaluate the long-term impact of frozen elephant trunk (FET) on the distal aorta of patients with Marfan syndrome (MFS) who had type I dissection confined to the thoracic aorta (above the diaphragmatic hiatus). ⋯ The FET technique has a positive remodeling impact on type I dissection confined to the thoracic aorta in patients with MFS. This study adds evidence supporting the safety and durability of this extended approach for type I aortic dissection in MFS.
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Multicenter Study
Postoperative Opioid Consumption in Thoracic Surgery Patients: How Much Is Actually Used?
The objective of this initiative was to perform a prospective, multicenter survey of patients after lung resection to assess the amount of opioid medication consumed and the disposition of unused opioids to inform the development of evidence-based prescribing guidelines. ⋯ Although patients undergoing MIS lung resection used significantly less opioid medication over a shorter duration of time than did patients after thoracotomy, they had relatively more excess opioid prescription. Evidence-based, procedure-specific guidelines with tailored pain regimens should be developed and implemented to reduce the amount of postoperative opioid medication remaining in the community.