The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Meta AnalysisOutcomes of marginal donors for lung transplantation after ex vivo lung perfusion: A systematic review and meta-analysis.
Ex vivo lung perfusion (EVLP) is reportedly a useful strategy that permits marginal donor lungs to be evaluated and reconditioned for successful lung transplantation (LTx). This systematic review and meta-analysis was performed to evaluate the outcomes of EVLP conducted for marginal donor lungs. ⋯ Posttransplant outcomes were similar between EVLP-treated LTx and standard LTx without EVLP, although the quality of donor lungs was worse with EVLP-treated LTx.
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Intraoperative transfusion and an increased preoperative C-reactive protein level are associated with higher mortality after off-pump coronary artery bypass grafting.
The effects of transfusion on clinical outcomes after cardiac surgery remain inconclusive. We hypothesized that the risk of postoperative cumulative long-term, all-cause mortality after transfusion in patients undergoing cardiac surgery would differ by individual inflammatory status reflected by C-reactive protein level; thus, we performed a retrospective study. ⋯ Intraoperative red blood cell transfusion in patients with increased C-reactive protein level was significantly related to the risk of mortality after off-pump coronary artery bypass grafting.
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Outcomes after thoracic endovascular aortic repair in patients with chronic kidney disease in the Medicare population.
Thoracic endovascular aortic repair has been increasingly performed in higher-risk patients with renal failure. The objective was to compare Medicare patients with preoperative chronic kidney disease with patients with normal renal function to determine differences in postoperative survival and complications. ⋯ In this elderly Medicare population undergoing thoracic endovascular aortic repair, patients with chronic kidney disease stage III, chronic kidney disease stage IV, or end-stage renal disease/hemodialysis had poor survival and increased morbidity compared with those with normal kidney function. These data may suggest that patients with chronic kidney disease stage III, chronic kidney disease stage IV, or end-stage renal disease/hemodialysis should be more cautiously evaluated for thoracic endovascular aortic repair, weighing the benefits of the procedure against the high expected mortality.
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Off-pump versus on-pump redo coronary artery bypass grafting: A propensity score analysis of long-term follow-up.
Redo coronary artery bypass grafting (CABG) is associated with an increased early mortality reported up to 16%. The aim of this study was to analyze the early and long-term results after redo CABG with special focus on the feasibility and safety of the off-pump technique in the setting of a high-volume off-pump CABG center. ⋯ In our study, patients undergoing off-pump redo CABG had fewer postoperative complications, achieved faster recovery, and had better long-term survival. Hence, off-pump redo CABG is safe and feasible.