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
Multicenter StudyTumor size as a prognostic factor in limited-stage thymic epithelial tumors: A multicenter analysis.
The prognostic significance of tumor size in thymic epithelial tumors (TETs) has not been fully evaluated. We aimed to clarify the prognostic value of tumor size in limited-stage and advanced-stage TETs. ⋯ Tumor size is an independent prognostic factor in patients with completely resected limited-stage TETs and a cutoff value >5.5 cm might help clinicians enact proper treatment strategies and surveillance.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Multicenter StudyThe impact of acute kidney injury by serum creatinine or urine output criteria on major adverse kidney events in cardiac surgery patients.
Oliguria after cardiac surgery remains of uncertain clinical significance. Therefore, we investigated the relationship of acute kidney injury severity across urine output and creatinine domains with the risk for major adverse kidney events at 180 days. We aimed to determine the impact of acute kidney injury after cardiac surgery. ⋯ Acute kidney injury is common in patients undergoing cardiac surgery, and even milder forms of acute kidney injury, including isolated stage 1 oliguria, are associated with adverse long-term consequences.
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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.