The Journal of thoracic and cardiovascular surgery
-
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.
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Preemptive pain-management program is associated with reduction of opioid prescriptions after benign minimally invasive foregut surgery.
The opioid crisis is partly due to opioids prescribed after elective surgery. We sought to determine if a preemptive pain-management program would be associated with opioid-free discharge after benign foregut surgery. ⋯ The preemptive pain-management program was associated with opioid-free discharge after minimally invasive foregut surgery. This study provides a strategy to reduce opioid prescriptions after foregut surgery and, if implemented nationally, could decrease the amount of opioids used in the community.
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Y-graft modification to the Fontan procedure: Increasingly balanced flow over time.
The use of Y-grafts for Fontan completion is hypothesized to offer more balanced hepatic flow distribution (HFD) and decreased energy losses. The purpose of this study was to evaluate the hemodynamic performance of Y-grafts over time using serial cardiac magnetic resonance data and to compare their performance with extracardiac Fontan connections. ⋯ Y-grafts showed significantly more balanced HFD over a 3-year follow-up without an increase in total cavopulmonary connection resistance, and therefore may be a valuable option for Fontan completion. Additional follow-up data at longer follow-up times are still needed to thoroughly characterize the potential advantages of Y-graft use.
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Longitudinal functional health status in young adults with repaired dextro-transposition of the great arteries: A Congenital Heart Surgeons' Society study.
Improved survival has led to interest in functional health status (FHS) as patients with dextro-transposition of the great arteries (d-TGA) transition to adulthood. Our primary objectives were (1) evaluation of The Medical Outcomes Study Short Form-36 Health Survey (SF-36) results; (2) comparison with results of patients who completed the Child Health Questionnaire-Child Form 87 (CHQ-CF87) previously, or the PedsQL Generic Core Scales (PedsQL) survey subsequently; and (3) determination of factors associated with SF-36 domains. ⋯ Patients with d-TGA surviving into adulthood, regardless of morphology or repair type, can primarily expect normal FHS. Addressing the challenges of patients with d-TGA entering adulthood requires consideration of psychosocial factors and clinical management.
-
J. Thorac. Cardiovasc. Surg. · Feb 2020
Evaluation of a hybrid small caliber vascular graft in a rabbit model.
A hybrid small-caliber artificial vascular graft based on bilayer porcine small intestinal submucosa (SIS) with curdlan and dipyridamole mixture film serving as the so-called sandwich filler was developed for biological performance evaluation. We evaluated the performance of the graft and filler. ⋯ The novel hybrid small caliber artificial vascular graft exhibited an improvement in revascularization resulting in high patency rate.