The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Multicenter StudyAssociation of atrial septal fenestration with outcomes after atrioventricular septal defect repair.
During repair of atrioventricular septal defect (AVSD), surgeons might leave an atrial level shunt when concerned about postoperative physiology, or as part of routine practice. However, the association of fenestration with outcomes is unclear. We sought to determine factors associated with mortality after biventricular repair of AVSD. ⋯ An atrial communication at biventricular repair of AVSD is associated with significantly reduced long-term survival after adjusting for other known associated factors, including unbalance. These findings might challenge the routine practice of fenestration.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Comparative StudyFactors associated with short- versus long-term survival after lung transplant.
A small but growing proportion of lung transplant recipients survive longer than a decade post-transplant. The aim of this study was to identify factors associated with survival beyond a decade after lung transplant. ⋯ Of patients undergoing lung transplantation after the implementation of the Lung Allocation Score, approximately one-quarter survived 10 years post-transplant. There was minimal overlap between the factors associated with 1-year and 10-year survival. Of note, the Lung Allocation Score was not associated with long-term survival. Further research is needed to better refine patient selection and optimize management strategies to increase the number of long-term survivors.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Observational StudyPreoperative clopidogrel and outcomes in patients with acute coronary syndrome undergoing coronary artery bypass surgery.
The optimal preoperative antiplatelet strategy for patients with acute coronary syndrome (ACS) requiring surgical revascularization remains unclear because of competing risks of bleeding and ischemic events. We evaluated the effect of clopidogrel within 5 days before coronary artery bypass grafting (CABG) on outcomes in patients with ACS. ⋯ Among patients with ACS undergoing CABG, clopidogrel therapy within 5 days before surgery was associated with increased odds of major cardiac and cerebrovascular events and bleeding complications than discontinuing clopidogrel for >5 days.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Multicenter Study Comparative StudyCurrent practice patterns for use of the radial artery for coronary surgery in dedicated centers.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Observational StudyGait speed is a preoperative indicator of postoperative events after elective proximal aortic surgery.
The study objective was to evaluate whether 5-m gait speed, an established marker of frailty, is associated with postoperative events after elective proximal aortic surgery. ⋯ Slow gait speed is a preoperative indicator of risk for postoperative events after elective proximal aortic surgery. Gait speed may be an important tool to complement existing operative risk models, and its application may identify patients who may benefit from presurgical and postsurgical rehabilitation.