The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2023
The Thoracic Surgery Medical Student Association: Understanding the needs of medical students pursuing cardiothoracic surgery in the United States.
Founded in 2020, the Thoracic Surgery Medical Student Association is the first national organization dedicated to supporting medical students interested in pursuing cardiothoracic surgery. Our inaugural survey aimed to describe their basic characteristics and needs. ⋯ There is a significant need to directly engage medical students who are interested in cardiothoracic surgery considering limited exposure at home institutions through a lack of cardiothoracic surgery interest groups and cardiothoracic residency programs. The Thoracic Surgery Medical Student Association is poised to address these areas with directed networking by connecting cardiothoracic surgery faculty and residents from other institutions with medical students interested in pursuing cardiothoracic surgery.
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J. Thorac. Cardiovasc. Surg. · Jul 2023
Observational StudyPostoperative delirium and quality of life after transcatheter and surgical aortic valve replacement: A prospective observational study.
In older patients, postoperative delirium is a frequently occurring complication after surgical aortic valve replacement, leading to an excess in postoperative morbidity and mortality. It remains controversial whether transcatheter aortic valve implantation and minimally invasive surgical aortic valve replacement can reduce the risk of postoperative delirium. This study aimed to compare the incidence of postoperative delirium after transcatheter aortic valve implantation and surgical aortic valve replacement and the impact on long-term outcomes. ⋯ Transcatheter aortic valve implantation is associated with a lower risk for postoperative delirium. Nevertheless, patients undergoing surgical aortic valve replacement experience the greatest improvement in quality of life. Heart teams should consider these outcomes in shared decision-making in the choice of transcatheter aortic valve implantation or surgical aortic valve replacement.
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J. Thorac. Cardiovasc. Surg. · Jul 2023
Adequate lung cancer surgery lymphadenectomy within a statewide quality collaborative: Quality improvement in action.
In January 2016, our statewide quality improvement collaborative focused on 3 metrics of adequate lymph node harvest during lung cancer surgery: (1) rates of pathologic examination of 10 lymph nodes or more; (2) sampling 5 or more lymph node stations or more within the hilum or mediastinum; and (3) pathologic nodal upstaging (pathologic nodal stage higher than clinical nodal stage). Unblinded, hospital-level outcomes were presented at biannual meetings, and opportunities for education or improvement were discussed. We set out to describe this quality improvement initiative and the subsequent impact on surgical lymphadenectomies statewide. ⋯ Our statewide quality improvement initiative improved rates of appropriate lymph node staging for surgically treated non-small cell lung cancer compared with national rates. This work demonstrates the power that a "community of practice" philosophy can have on surgical treatment of lung cancer. Quality improvement interventions including transparent data-driven discussions and collaboration can help guide future quality improvement initiatives and should be readily transferrable to other clinical domains.
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J. Thorac. Cardiovasc. Surg. · Jul 2023
Outcomes of temporary ventricular assist device: A pediatric institutional experience over 25 years.
There are scarce data describing outcomes of pediatric temporary ventricular assist device support. ⋯ This study suggests temporary ventricular assist device support is feasible in children with favorable outcomes.