The Annals of thoracic surgery
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The Society of Thoracic Surgeons (STS) Workforce on Research Development and the STS Research Center currently offer 3 outcomes research platforms using the STS General Thoracic Surgery Database: (1) the traditional Access and Publications Program supports STS-sponsored projects with data analysis conducted at an STS-approved data analytic center, (2) the STS Task Force for Funded Research supports STS investigators pursuing extramural research funding for projects incorporating STS National Database data linked to other data sets such as Centers for Medicare and Medicaid Services, and (3) the Participant User File (PUF) program that provides deidentified patient-level data files from the STS General Thoracic Surgery Database to investigators with approved projects to be analyzed at their institution. This report includes an updated review of each program in addition to an outline of 2019-based articles published or accepted.
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Comparative Study
Outcomes of Operative and Nonoperative Treatment of Thoracic Empyema: A Population-Based Study.
The optimal management of thoracic empyema remains unclear. This study compared mortality and readmission risk after operative vs nonoperative treatment of thoracic empyema. ⋯ Nonoperative management of thoracic empyema was associated with higher risk of mortality compared with surgical decortication. Early thoracic surgical consultation is recommended.
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The Fontan procedure is the accepted standard for single-ventricle palliation. The goal of this study was to determine short- and midterm outcomes of patients undergoing a Fontan operation at a single institution and to identify contemporary risk factors for acute and chronic failure. ⋯ Contemporary midterm outcomes for Fontan patients are reassuring. Lifelong follow-up is mandatory to determine long-term outcomes and need for additional surgery as patients reach adulthood.
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Outcome data of patients with acute myocardial infarction (AMI)-induced cardiogenic shock (CS) receiving extracorporeal life support (ECLS) are sparse. ⋯ Emergency ECLS is a valuable option among patients with AMI-induced CS with low and intermediate IABP-SHOCK II risk scores. ECLS weaning is manageable, but additional revascularization of all nonculprit lesions is mandatory after ECLS implementation.
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Right ventricular failure (RVF) is one of the major adverse events after left ventricular assist device (LVAD) implantation. Right ventricle (RV) distensibility plays a key role in the preload reserve capability and in RV ejection through the Frank-Starling mechanism. However, there are no studies focusing on the relationship between RVF and RV distensibility. ⋯ Less distensible RV and elevated central venous pressure/pulmonary capillary wedge pressure level were significant risks for RVF after LVAD implantation. This result suggested that analysis of not only the hemodynamic numbers but also the pattern of waveforms are important to assess risk for RVF in LVAD candidates.