The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Meta AnalysisEfficacy and effectiveness of on- versus off-pump coronary artery bypass grafting: A meta-analysis of mortality and survival.
Despite many studies comparing on- versus off-pump coronary artery bypass graft (CABG), there is no consensus as to whether one of these techniques offers patients better outcomes. ⋯ Evidence from RCTs showed no differences between the techniques, whereas rigorously adjusted observational studies (with >1.1 million patients) and the combined analysis indicated that off-pump CABG offers lower short-term mortality but poorer long-term survival. These results suggest that, in real-world settings, greater operative safety with off-pump CABG comes at the expense of lasting survival gains.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Meta AnalysisSystematic review and meta-analysis of chordal replacement versus leaflet resection for posterior mitral leaflet prolapse.
To compare outcomes of chordal replacement versus leaflet resection techniques for repair of isolated posterior mitral leaflet prolapse. ⋯ Chordal replacement may be associated with greater freedom from reoperation and may lead to improved postoperative left ventricular function compared with leaflet resection. However, these conclusions are supported primarily by data from unadjusted observational studies, and high-quality RCTs of chordal replacement versus leaflet resection are needed.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Survival and long-term outcomes after mitral valve replacement in patients aged 18 to 50 years.
To provide long-term data on survival and major morbidity after mitral valve replacement in patients aged 18 to 50 years. ⋯ The significant survival benefit associated with mechanical mitral valve replacement in adults ≤50 years may be due to the practice of implanting bioprostheses in sicker patients or those judged less likely to comply with long-term medication despite adjustment for baseline characteristics in propensity score matching.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Prognostic impact of programmed death-ligand 1 expression in correlation with human leukocyte antigen class I expression status in stage I adenocarcinoma of the lung.
The study objective was to investigate the prognostic impact of programmed death-ligand 1 expression in correlation with human leukocyte antigen class I expression on tumor cells in early-stage adenocarcinoma of the lung, because both programmed death-ligand 1 and human leukocyte antigen class I molecules play important roles in cancer immunity. ⋯ The prognostic impact of programmed death-ligand 1 expression on tumor cells in early-stage lung adenocarcinoma may be distinct according to concurrent human leukocyte antigen class I expression.