The Annals of thoracic surgery
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Comparative Study
Septuagenarians bridged to heart transplantation with a ventricular assist device have outcomes similar to younger patients.
Although orthotopic heart transplantation (OHT) is increasingly being offered to older patients, few studies have evaluated outcomes in patients older than 70 years of age. We undertook this study to characterize the outcomes of septuagenarians bridged to transplantation (BTT) in the modern era. ⋯ Although patients older than the age of 70 years undergoing OHT have decreased survival, among patients who received BTT, septuagenarians have outcomes similar to those of younger recipients. In carefully selected patients dependent on left ventricular assist devices (LVADs), recipient age greater than or equal to 70 years should not be viewed as a contraindication to OHT.
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Comparative Study
Surgery in adults with congenital heart disease: risk factors for morbidity and mortality.
Patients with congenital heart disease are frequently surviving into adulthood, and many of them will require surgery. Unfortunately, outcome data in this patient population are limited. We aimed to identify risk factors associated with adverse events in adults with congenital heart disease undergoing cardiac surgery and establish long-term survival data. ⋯ Surgery in adults with congenital heart disease can be performed with low morbidity and mortality. Nonetheless, there remain important risk factors for adverse events. Awareness and modification of risk factors may help improve outcomes.
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Comparative Study
Readmissions after ventricular assist device: etiologies, patterns, and days out of hospital.
Scarce literature exists describing the patterns of readmission after continuous flow left ventricular assist device (CF-LVAD) implantation. These carry significant cost and quality of life implications. We sought to describe the etiology and pattern of readmission among patients receiving CF-LVADs. ⋯ Patients undergoing CF-LVAD support are often readmitted within 6 months of discharge. Readmissions tend to be of short duration and the most common reason is for gastrointestinal bleeding. Importantly, following discharge after implant procedure, 51 patients spent at least 90% of days OOH.
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Multicenter Study Comparative Study
Impact of surgeon demographics and technique on outcomes after esophageal resections: a nationwide study.
Thoracic, cardiac, and general surgeons perform esophageal resections in the United States. This article examines the impact of surgeon subspecialty on outcomes after esophagectomy. ⋯ General surgeons perform the major proportion of esophagectomies in the United States. Surgeon subspecialty is not associated with the risk of complications developing but instead is associated with mortality and failure to rescue from complications. Surgeon subspecialty case mix is an important determinant of outcomes for patients undergoing esophagectomy.