The Annals of thoracic surgery
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Multicenter Study Comparative Study
Trends in acute kidney injury, associated use of dialysis, and mortality after cardiac surgery, 1999 to 2008.
The development of acute kidney injury (AKI) after cardiac surgery is associated with significant mortality, morbidity, and cost. The last decade has seen major changes in the complexity of cardiac surgical candidates and in the number and type of cardiac surgical procedures being performed. ⋯ In sum, despite improvements in individual patient outcomes over the decade 1999 to 2008, the population contribution of AKI and AKI-D to inpatient mortality after surgery increased over the same period.
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Multicenter Study Comparative Study
Clinical characteristics and prognostic factors of primary pulmonary vein stenosis or atresia in children.
Primary pulmonary vein stenosis or atresia (PVS/A) is a rare entity with a high mortality rate. The aim of this study was to elucidate the clinical characteristics, progression, and prognostic factors of primary PVS/A in children. ⋯ Primary PVS/A may carry a significant risk of recurrent and progressive PV obstruction or death even after surgical venoplasty.
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Comparative Study
Dynamic 3-dimensional echocardiographic assessment of mitral annular geometry in patients with functional mitral regurgitation.
Mitral valve (MV) annular dynamics have been well described in animal models of functional mitral regurgitation (FMR). Despite this, little if any data exist regarding the dynamic MV annular geometry in humans with FMR. In the current study we hypothesized that 3-dimensional (3D) echocardiography, in conjunction with commercially available software, could be used to quantify the dynamic changes in MV annular geometry associated with FMR. ⋯ There are significant differences in dynamic mitral annular geometry between patients with FMR and those without. We were able to analyze these changes in a clinically feasible fashion. Ready availability of this information has the potential to aid comprehensive quantification of mitral annular function and possibly assist in both clinical decision making and annuloplasty ring selection.
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Comparative Study
The risk and outcomes of reoperative tricuspid valve surgery.
Outcomes after tricuspid valve reoperation have not been published before. This study examines our 32-year experience in this cohort of patients. ⋯ Redo tricuspid valve surgery is associated with high operative mortality and morbidity; however, survivors benefited from reasonable survival rates. Re-repair of the tricuspid valve is feasible in the majority of patients with functional tricuspid valve pathology, while the majority of patients with underlying organic pathology required a valve replacement.
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Comparative Study
Role of blebs and bullae detected by high-resolution computed tomography and recurrent spontaneous pneumothorax.
The prevention of recurrence after a first episode of primary spontaneous pneumothorax (PSP) remains a debated issue. The likelihood of recurrence based on the presence of blebs and bullae detected on high-resolution computed tomography (HRCT) imaging is controversial. ⋯ The presence of blebs and bullae at HRCT after a first episode of PSP is significantly related to the development of an ipsilateral recurrence or a contralateral episode of pneumothorax. Further studies are needed to validate the dystrophic severity score in the selection of patients for early surgical referral.