The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2017
New-onset postoperative atrial fibrillation after aortic valve replacement: Effect on long-term survival.
There is a paucity of data on long-term survival of new-onset postoperative atrial fibrillation (POAF) after cardiac surgery. Also, mean follow-up in previous studies is confined to a maximum of one decade. This retrospective, longitudinal cohort study was performed to determine the effect on long-term survival of new-onset POAF after aortic valve replacement (AVR) over a mean follow-up of almost 2 decades. ⋯ New-onset POAF after AVR does not affect long-term survival when treatment is aimed to restore sinus rhythm before discharge home.
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J. Thorac. Cardiovasc. Surg. · Aug 2017
Comparative StudyA national analysis of wedge resection versus stereotactic body radiation therapy for stage IA non-small cell lung cancer.
Lobectomy is considered optimal therapy for early-stage non-small cell lung cancer, but sublobar wedge resection and stereotactic body radiation therapy are alternative treatments. This study compared outcomes between wedge resection and stereotactic body radiotherapy. ⋯ In this national analysis, wedge resection was associated with better survival for stage IA non-small cell lung cancer than stereotactic body radiotherapy.
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J. Thorac. Cardiovasc. Surg. · Aug 2017
Readmission rates after transcatheter aortic valve replacement in high- and extreme-risk patients with severe aortic stenosis.
In high- or extreme-risk patients undergoing transcatheter aortic valve replacement, readmissions have not been adequately studied and are the subject of increased scrutiny by healthcare systems. The objectives of this study were to determine the incidence of 30-day and 1-year cardiac and noncardiac readmissions, identify predictors of readmission, and assess the association between readmission and 1-year mortality. ⋯ We show some baseline comorbidities and procedural complications that are directly associated with early and late readmissions, and anemia and postoperative stroke were associated with an increase in mortality. Moreover, we found that readmission was associated with double the hazard of death within 1 year. Whether treatment of identified risk factors could decrease readmission rates and mortality warrants further investigation.
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J. Thorac. Cardiovasc. Surg. · Aug 2017
Comparative StudyPre- versus postoperative chemoradiotherapy for locally advanced esophageal squamous cell carcinoma.
Although preoperative chemoradiation followed by surgery has been recognized as an efficient strategy for esophageal cancer treatments, several studies demonstrate survival benefits of postoperative chemoradiation for those undergoing upfront resection. The optimal sequence of surgery and chemoradiation remains unclear. ⋯ Similar outcome can be achieved with postoperative chemoradiotherapy compared with preoperative chemoradiotherapy in patients with locally advanced ESCC. There is little difference between these 2 strategies.