The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Multicenter Study Observational StudyTranscatheter aortic valve implantation in patients with severe aortic valve stenosis and large aortic annulus, using the self-expanding 31-mm Medtronic CoreValve prosthesis: first clinical experience.
With the introduction of the 31-mm Medtronic CoreValve prosthesis, patients with large aortic annulus have become eligible for transcatheter aortic valve implantation. The aim of this study was to evaluate the feasibility, efficacy, and safety of transcatheter aortic valve implantation using the 31-mm Medtronic CoreValve in patients with severe aortic valve stenosis and large aortic annulus. ⋯ In this retrospective multicenter registry, transcatheter treatment of severe aortic valve stenosis with the 31-mm Medtronic CoreValve seemed to be challenging, even in experienced hands. If the prosthesis is properly implanted, it offers adequate valve hemodynamics and proper functioning.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Comparative StudySame-day cancellation of cardiac surgery: a retrospective review at a large academic tertiary referral center.
Same-day cancellations of cardiac surgery are unfortunate and costly occurrences that potentially place patients at risk of adverse events. ⋯ Same-day cancellation of cardiac surgery occurred infrequently (2% of cardiac operations performed) at our institution. The cancellations were for foreseeable causes in a few cases. Seeing a nonsurgeon provider more recently before cancellation was not significantly associated with nonforeseeable versus foreseeable cancellations. Although uncommon at our institution, same-day cancellations should be viewed as an opportunity for practice improvement, given the foreseeable nature of some cancelations, associated 30-day mortality, and portion of patients not subsequently undergoing cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Nationwide survey of US integrated 6-year cardiothoracic surgical residents.
Integrated 6-year cardiothoracic surgical residency programs have recently been implemented in the United States. We report the results of the first published nationwide survey assessing the motivations, satisfaction, and ambitions of integrated 6-year residents. ⋯ This survey takes an important snapshot of the nascent integrated 6-year format. Mentorship and intense clinical exposure are critical in attracting applicants. Purported advantages of the format are holding true among integrated 6-year residents, with the majority satisfied with their programs. These early data indicate that this format holds significant promise in attracting and retaining highly qualified trainees to academic cardiothoracic surgery.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Surgical anterior ventricular endocardial restoration performed with total arterial revascularization: serial 5-year follow-up.
We evaluated the changes in left ventricular (LV) function and volumes after surgical anterior ventricular endocardial restoration. ⋯ Improved LV ejection fraction and reduced volume indexes were maintained and the stroke volume index had not decreased at 5 years after the procedure. Preserved patency of the arterial grafts might have an important role in maintaining improved LV function.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Smoking cessation before coronary artery bypass grafting improves operative outcomes.
The detrimental effect of active smoking on operative outcome after coronary artery bypass grafting (CABG) is still debated and smoking cessation programs are usually deferred until after surgery. The potential benefit from smoking cessation on postoperative outcomes is investigated in this study. ⋯ This study showed that smoking cessation before CABG reduced the risk of serious pulmonary complications. The present findings indicate that embarking on a smoking cessation program should not be deferred until after surgery.