The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Multicenter Study Clinical TrialOne-year results of thoracic endovascular aortic repair for blunt thoracic aortic injury (RESCUE trial).
One-year outcomes of the RESCUE trial (endovascular aortic repair using Valiant Captivia for blunt thoracic aortic injury) are reported. ⋯ TEVAR has favorable early midterm outcomes in the treatment of blunt thoracic aortic injury, and remains the treatment modality of choice. Longevity of the stent grafts in this young patient population has yet to be established.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Randomized Controlled Trial Comparative StudyDo differences in early hemodynamic performance of current generation biologic aortic valves predict outcomes 1 year following surgery?
Small early postoperative hemodynamic differences were noted in a randomized comparison of 3 current-generation bioprosthetic aortic valves. Whether these differences persist and influence clinical outcomes 1 year following implantation is unknown. ⋯ Despite midterm persistence of small hemodynamic differences amongst current-generation porcine and pericardial aortic valves, our prospective randomized comparison reveals that clinical outcomes and mass regression are equivalent between devices at 1 year. These encouraging trends must continue to be assessed during longitudinal follow-up.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Multicenter StudyOutcome of primary neuroendocrine tumors of the thymus: a joint analysis of the International Thymic Malignancy Interest Group and the European Society of Thoracic Surgeons databases.
Primary neuroendocrine tumors of the thymus (TNET) are exceedingly rare. We studied a large series of TNET identified through the International Thymic Malignancy Interest Group and the European Society of Thoracic Surgeons databases. ⋯ Our results confirm the high biologic aggressiveness of these rare neoplasms; pathologic stage and completeness of resection were demonstrated to be strong prognostic factors, whereas histology did not influence patients outcome.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Randomized Controlled TrialPractice improves performance on a coronary anastomosis simulator, attending surgeon supervision does not.
Enthusiasm for simulation early in cardiothoracic surgery training is growing, yet evidence demonstrating its utility is limited. We examined the effect of supervised and unsupervised training on coronary anastomosis performance in a randomized trial among medical students. ⋯ Practice on low-fidelity simulators enabled trainees to improve on a broad range of skills; however, the additional effect of attending-level supervision is limited. In an era of increasing staff surgeon responsibilities, unsupervised practice may be sufficient for inexperienced trainees.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Randomized Controlled TrialPresurgical levels of circulating cell-derived microparticles discriminate between patients with and without transfusion in coronary artery bypass graft surgery.
Improved understanding of presurgical risk factors for transfusions will lead to reduction in their number and related complications. The goal of this study is to identify these factors in coronary artery bypass graft (CABG) surgery. ⋯ Presurgical levels of CD41(+) PMPs and CD235a(+) RMPs are the main risk factors for transfusion in CABG, followed by HGB and aPTT.