The Annals of thoracic surgery
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Transapical, beating heart, off-pump implantation of neochordae for repair of mitral valve (MV) prolapse is of increasing interest. The aim of this study was to evaluate long term results for MV repair using the NeoChord system (NeoChord, St. Louis Park, MN). ⋯ In select patients, MV repair using the NeoChord system results in very good long-term results without recurrent prolapse, MR, or annular dilatation.
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Obtaining National Institutes of Health (NIH) R01 funding remains extremely difficult. The utility of career development grants (K awards) for achieving the goal of R01 funding remains debated, particularly for surgeon-scientists. We examined the success rate for cardiothoracic and vascular (CTV) surgeons compared with other specialties in converting K-level grants into R01 equivalents. ⋯ CTV surgeons have an equal 10-year conversion rate to the first R01 award compared with other clinicians. These data suggest that NIH achieves a good return on investment when funding CTV surgeon-scientists with K-level funding.
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We describe a hybrid surgical interventional technique for minimally invasive implantation of a transcatheter aortic valve in the mitral position. This technique does not require circular mitral annular calcification and minimizes the risk of left ventricular outflow tract obstruction. We believe this technique represents a useful approach for surgeons and interventional cardiologists until specialized transcatheter mitral valve devices become available.
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Comparative Study
Coronary Revascularization With Single Versus Bilateral Mammary Arteries: Is It Time to Change?
Arterial conduits are preferred to venous conduits for coronary artery bypass grafting because of longer patency. A single internal mammary artery (SIMA) is used routinely. Bilateral internal mammary arteries (BIMA) are used less frequently. We sought to determine whether BIMA were superior to SIMA. ⋯ In a large regional experience, BIMA is associated with no upfront risk of adverse events and improved long-term survival compared with SIMA. Our results indicate that BIMA conduits should be considered more frequently during coronary artery bypass grafting due to their demonstrated survival advantage.
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Comparative Study
Enhanced Recovery Decreases Pulmonary and Cardiac Complications After Thoracotomy for Lung Cancer.
Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices, including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. This study evaluated outcomes after implementation of ERAS in patients undergoing resection for pulmonary malignancy. ⋯ ERAS was associated with improved postoperative outcomes, including decreased length of stay and pulmonary and cardiac morbidity after thoracotomy, but not after minimally invasive operations. ERAS safety was demonstrated by low rates of adverse events without effect on hospital readmission or perioperative deaths.