The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2020
Multicenter StudyImpact of transfer status on real-world outcomes in nonelective cardiac surgery.
Transfer from hospital to hospital for cardiac surgery represents a large portion of some clinical practices. Previous literature in other surgical fields has shown worse outcomes for transferred patients. We hypothesized that transferred patients would be higher risk and demonstrate worse outcomes than those admitted through the emergency department. ⋯ Transfer patients have similar rates of postoperative complications but increased resource use compared with patients admitted through the emergency department. Patients transferred from centers that perform cardiac surgery represent a particularly high-risk subgroup.
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J. Thorac. Cardiovasc. Surg. · Feb 2020
Multicenter StudyOutcomes of major complications after robotic anatomic pulmonary resection.
There is a paucity of robust clinical data on major postoperative complications following robotic-assisted resection for primary lung cancer. This study assessed the incidence and outcomes of patients who experienced major complications after robotic anatomic pulmonary resection. ⋯ In this series, the major complication rate during the postoperative period was 4.3%. A number of identified patient- and treatment-related factors were associated with an increased risk of major complications. Major complications had a significant impact on mortality and duration of stay.
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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.
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J. Thorac. Cardiovasc. Surg. · Feb 2020
Biofilm formation and migration on ventricular assist device drivelines.
Driveline infections remain an important complication of ventricular assist device therapy, with biofilm formation being a major contributor. This study aimed to elucidate factors that govern biofilm formation and migration on clinically relevant ventricular assist device drivelines. ⋯ This work highlights the predilection of pathogens to different parts of the driveline, the importance of the subcutaneous tunnel to biofilm formation and migration, and the presence of micro-gaps in clinical drivelines that could facilitate invasive driveline infections.
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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.