The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Comparative StudyComparison of mid-term outcomes of endovascular repair and medical management in patients with acute uncomplicated type B aortic dissection.
To further assess the early and mid-term outcomes of thoracic endovascular aortic repair (TEVAR) in patients with acute uncomplicated type B aortic dissection (TBAD) compared with those receiving best medical treatment (BMT). ⋯ Despite more complications in the early stage, TEVAR was associated with decreased risk of late death and had fewer late aortic ruptures compared with BMT in patients with acute uncomplicated TBAD. Therefore, TEVAR may be considered as the first option to improve the late outcomes in these patients.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Daytime variation does not impact outcome of cardiac surgery: Results from a diverse, multi-institutional cardiac surgery network.
Recent single-center and experimental data suggested greater adverse cardiac events for patients undergoing aortic valve replacement (AVR) in the morning (AM) versus the afternoon (PM). However, previous studies in patients undergoing coronary artery bypass grafting (CABG) have found no similar time-related difference. We examined the impact of AM versus PM operative time on surgical outcomes of CABG and AVR in a diverse, multi-institutional cardiac surgery network between January 2008 and September 2018. ⋯ There were no differences in operative mortality nor in major morbidity between well-matched AM and PM patients undergoing either CABG or AVR.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Left atrial assist device to treat patients with heart failure with preserved ejection fraction: Initial in vitro study.
Many patients with heart failure have preserved ejection fraction but also diastolic dysfunction, with no effective therapy. We are developing a new pump (left atrial assist device, LAAD) for implantation at the mitral position to pump blood from the left atrium to sufficiently fill the left ventricle. The purpose of the initial in vitro study was to demonstrate that the LAAD can reduce left atrial pressure (LAP) and increase cardiac output (CO) while maintaining arterial pulsatility and normal aortic valve function using a proof-of-concept device. ⋯ These initial in vitro results support our hypothesis that use of the LAAD increases CO and AoP and decreases LAP under DHF conditions while maintaining arterial pulsatility and full function of the aortic valve.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Effect of primary colorectal cancer tumor location on survival after pulmonary metastasectomy.
Although colorectal cancer bowel segment location has been shown to independently predict the outcomes in early stage disease, it has not been previously studied in the setting of pulmonary metastases. We sought to determine whether colorectal cancer location affects survival after pulmonary metastasectomy. ⋯ We found that left-sided colorectal cancer is associated with prolonged survival after pulmonary metastasectomy. Future investigations are required to determine the validity of such findings, including the effect of location in the prognostication for patients who are candidates for pulmonary metastasectomy.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Postoperative opioid use after lobectomy for primary lung cancer: A propensity-matched analysis of premier hospital data.
To evaluate opioid administration after robotic lobectomy (RL) compared with video-assisted thoracic surgery (VATS) and open lobectomy in patients with lung cancer. ⋯ Patients undergoing RL for primary lung cancer received opioids less frequently, and with lower total and average daily doses, compared with those undergoing VATS and open lobectomy. Studies are needed to determine whether early opioid dosage reductions translate into less chronic opioid use.