The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Meta AnalysisComparison of catheter and surgical ablation of atrial fibrillation: A systemic review and meta-analysis of randomized trials.
To compare both the beneficial and adverse effects of catheter ablation (CA) and surgical ablation (SA) on patients with atrial fibrillation (AF). ⋯ SA confers a moderate advantage over CA in 1-year efficacy outcomes and may be safely performed by experienced surgeons.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Randomized Controlled Trial Multicenter Study Comparative StudyEffect of total arterial grafting in the Arterial Revascularization Trial.
The Arterial Revascularization Trial (ART) was designed to compare 10-year survival in bilateral versus single internal thoracic artery grafts. The intention-to-treat analysis has showed comparable outcomes between the 2 groups but an explanatory analysis suggested that those receiving 2 or more arterial grafts had better survival. Whether the exclusive use of arterial grafts provide further benefit is unclear. ⋯ When compared with SAG, both MAG and TAG represent valuable strategies to improve clinical outcomes following coronary artery bypass grafting but TAG can potentially provide further benefit.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Multicenter StudyLong-term outcomes of atrioventricular septal defect and single ventricle: A multicenter study.
The study objective was to analyze survival and incidence of Fontan completion of patients with single-ventricle and concomitant unbalanced atrioventricular septal defect. ⋯ The long-term survival and incidence of Fontan completion in our study were better than previously described for patients with single-ventricle atrioventricular septal defect. A concomitant atrioventricular valve procedure did not increase the mortality rate or decrease the incidence of Fontan completion, whereas patients with moderate-severe or severe valve regurgitation at follow-up had a worse survival. Therefore, in patients with single-ventricle atrioventricular septal defect when atrioventricular valve regurgitation exceeds a moderate degree, the atrioventricular valve should be repaired.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Cardiac surgery outcomes in patients with coronavirus disease 2019 (COVID-19): A case-series report.
The impact of coronavirus disease 2019 (COVID-19) on the postoperative course of patients after cardiac surgery is unknown. We experienced a major severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in our cardiac surgery unit, with several patients who tested positive early after surgery. Here we describe the characteristics, postoperative course, and laboratory findings of these patients, along with the fate of the health care workers. We also discuss how we reorganize and reallocate hospital resources to resume the surgical activity without further positive patients. ⋯ COVID-19 infection after cardiac surgery, regardless the time of the onset, is a serious condition. The systemic inflammatory state that follows extracorporeal circulation may mask the typical COVID-19 laboratory findings, making the diagnosis more difficult. A strict reorganization of the hospital resources is necessary to safely resume the cardiac surgical activity.