The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Quantitative assessment of technical performance during hands-on surgical training of the arterial switch operation using 3-dimensional printed heart models.
Data supporting the use of hands-on simulation in congenital heart surgery are promising but primarily qualitative. This study aimed to demonstrate if there was an objective improvement in time and technical performance of the arterial switch procedure on 3-dimensional printed heart models by surgeons using a validated assessment method. ⋯ This is the first study to demonstrate an objective improvement in time and technical performance of the arterial switch procedure on 3-dimensional printed heart models. This supports the evidence that simulation in the form of deliberate practice with constructive, objective feedback is fundamental in the training of future congenital heart surgeons. These simulations and assessments should be incorporated to create structured, standardized training curricula within congenital heart surgery.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Abnormal left ventricular flow organization following repair of tetralogy of Fallot.
Left ventricular intracavitary flow (LVICF) characteristics reflect diastolic function. Right ventricular (RV) volume overload due to pulmonary regurgitation (PR) adversely impacts interventricular interactions and left ventricular (LV) function. This aimed to determine whether patients with PR and mild to moderate RV dilation after repair of tetralogy of Fallot (TOF) repair have abnormal LVICF, and to determine whether RV dilation and biventricular function correlate with LVICF abnormalities. ⋯ Patients with repaired TOF with mild to moderate RV dilation have abnormal LV diastolic direct flow and increased recirculating residual volume. These changes correlate with the degree of RV dilation and impaired LV function.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Single running suture technique is associated with low rate of bronchial complications after lung transplantation.
Lung transplantation has evolved to a routinely performed surgical procedure in patients with end-stage pulmonary disease. Bronchial healing problems are rare but represent a potential life-threatening complication. Herein, we aimed to define the incidence, classification, and treatment of bronchial complications after lung transplantation. ⋯ The single running suture technique is associated with a very low rate of true anastomotic complications. Close follow-up and early endoscopic treatment of patients with anastomotic complications result in excellent long-term outcomes.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Impact of shaggy aorta on outcomes of open thoracoabdominal aortic aneurysm repair.
The aim of this study was to evaluate the impact of diffuse aortic atherosclerosis-related thrombosis, or "shaggy aorta" on the outcomes of open thoracoabdominal aortic aneurysm repair (TAAA). ⋯ Preoperative enhanced computed tomography assessment of shaggy aorta could predict high-risk patients for open TAAA repair.