The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2019
Aortic remodeling after hybrid provisional extension to induce complete attachment aortic repair of chronic residual type I aortic dissection.
Our objective was to examine the role of the provisional extension to induce complete attachment (PETTICOAT) aortic dissection repair technique with bare metal stents (BMSs) in abdominal remodeling of residual DeBakey type I aortic dissection. ⋯ Following reintervention for chronic residual DeBakey type I aortic dissection, PETTICOAT abdominal dissection BMS effectively expanded the thoracic and abdominal true lumen and augmented false lumen thrombosis percentage during the first postoperative year.
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J. Thorac. Cardiovasc. Surg. · Oct 2019
Chest tube removal algorithm is associated with decreased chest tube duration in pediatric cardiac surgical patients.
Management of chest tubes in adult and pediatric patients is highly variable. There are no published guidelines for pediatric cardiac surgical patients. Our center undertook a quality improvement project aimed at reducing chest tube duration and length of stay in postsurgical pediatric cardiac patients. ⋯ Implementation of a chest tube removal algorithm for pediatric cardiac surgery patients resulted in decreased chest tube duration and was associated with decreased length of stay and costs without an increase in reinsertions. More significant impact may be attainable with more aggressive approach to removal.
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J. Thorac. Cardiovasc. Surg. · Oct 2019
Determinants of acute events leading to mortality after shunt procedure in univentricular palliation.
The study objective was to identify determinants of adverse outcomes in patients undergoing univentricular palliation after the shunt procedure. ⋯ More than one-fifth of patients shunted during univentricular palliation die before the second stage. The majority of these deaths are associated with acute events occurring early after surgery. Strategies to improve survival should focus on prevention and management of acute events.
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J. Thorac. Cardiovasc. Surg. · Oct 2019
Cumulative nonsmoking risk factors increase the probability of developing lung cancer.
It is estimated that 20% of lung cancer cases in the United States are among never smokers, yet current screening recommendations only include a small subset of high-risk patients. In this study, 2 models were used to predict the risk of developing lung cancer in subgroups of never smoking patients with additional risk variables. ⋯ Models such as LLP and PLCO might be used to identify risk for patients who would otherwise not receive lung cancer screening. These individual risk assessments can be used by patients and providers to assess if one is at substantial risk for developing lung cancer.