The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2021
Understanding thoracic surgeons' perceptions of administrative database analyses and guidelines in clinical decision-making.
This study explored cardiothoracic surgeons' perceptions of health services research and practice guidelines, particularly how both influence providers' clinical decision-making. ⋯ Health services research, including database analyses, comprise much of the surgical literature; however, this study suggests that perceptions of database analyses and guidelines are mixed and questions whether thoracic surgeons routinely use either to inform their decisions. Researchers must address how to present compelling data to influence clinical practice.
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J. Thorac. Cardiovasc. Surg. · Mar 2021
Comparative Study Observational StudyMidterm outcomes of the Potts shunt for pediatric pulmonary hypertension, with comparison to lung transplant.
For children with severe pulmonary hypertension, addition of Potts shunt to a comprehensive palliation strategy might improve the outcomes afforded by medications and delay lung transplantation. ⋯ Potts shunt is an effective palliation for children with suprasystemic pulmonary hypertension that may become part of a strategy to maximize longevity and functional status for these challenging patients.
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J. Thorac. Cardiovasc. Surg. · Mar 2021
Observational StudyFirst in human experience with an epicardial beating heart device for secondary mitral regurgitation.
We describe a novel, off-pump, epicardial implant that is intended to reshape both the mitral valve annulus and the left ventricle (LV) in those with secondary mitral regurgitation (MR). ⋯ The Epicardial Mitral Touch System for Mitral Regurgitation (ENRAPT-MR) study demonstrates a first-in-man, off-pump, epicardial repair of secondary MR. Procedural safety and geometric correction of the mitral valve apparatus and LV was achieved. Further studies in the United States are underway.
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J. Thorac. Cardiovasc. Surg. · Mar 2021
Long-term outcomes following Fontan takedown in Australia and New Zealand.
Fontan takedown remains an option for the management of Fontan failure. We sought to evaluate early and late outcomes after Fontan takedown. ⋯ The incidence of Fontan takedown is low, but mortality is high. The majority of takedowns occurred within 6 months. Mortality was lowest when takedown occurred <2 days and highest between 3 weeks and 6 months. A second Fontan is possible in a small proportion of survivors.
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J. Thorac. Cardiovasc. Surg. · Mar 2021
Trends in the traditional cardiothoracic surgery resident operative experience for cardiac cases: An analysis of Accreditation Council for Graduate Medical Education case logs.
To determine whether the changing cardiac landscape has affected traditional cardiothoracic surgery (CTS) resident case volume, particularly cardiac case volume. ⋯ The overall CTS resident operative experience has increased over the last several years, with cardiac cases increasing more slowly than thoracic cases. The analysis reveals that cardiac operative volume has been asymmetrically allocated to cardiac track residents, indicating a greater specialization of the tracks. Annual evaluation of CTS resident case volume will provide essential insight into the field.