The Journal of thoracic and cardiovascular surgery
-
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.
-
J. Thorac. Cardiovasc. Surg. · Jan 2018
Multicenter StudyImprovement in TNM staging of pulmonary neuroendocrine tumors requires histology and regrouping of tumor size.
Neuroendocrine tumors of the lung are currently staged with the 7th edition TNM non-small cell lung cancer staging system. This decision, based on data analysis without data on histology or disease-specific survival, makes its applicability limited. This study proposes a specific staging system for these tumors. ⋯ Incorporating histology and regrouping tumor stage create a unique neuroendocrine tumor staging system that seems to predict survival better than the 7th TNM classification.
-
J. Thorac. Cardiovasc. Surg. · Jan 2018
Comparative StudyMitral valve surgery in the US Veterans Administration health system: 10-year outcomes and trends.
To compare mitral valve repair (MVRepair) and mitral valve replacement (MVReplace) trends in the Veterans Affairs (VA) Surgical Quality Improvement Program. ⋯ In the VA Health System, mortality after MV operations is low. Despite the survival advantage associated with MV repair in primary mitral regurgitation, repair is infrequent at some centers, representing an opportunity for quality improvement.
-
J. Thorac. Cardiovasc. Surg. · Jan 2018
Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases.
The study objective was to assess the technical and process improvement and clinical outcomes of robotic mitral valve surgery by examining the first 1000 cases performed in a tertiary care center. ⋯ Robotic mitral valve surgery is associated with a high likelihood of valve repair and low operative mortality and morbidity. The combination of algorithm-driven patient selection and increased experience enhanced clinical outcomes and procedural efficiency.
-
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.