The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Contemporary socioeconomic-based disparities in cardiac surgery: Are we closing the disparities gap?
Female sex and lower income residence location are associated with worse health care outcomes. In this study we analyzed the national, contemporary status of socioeconomic disparities in cardiac surgery. ⋯ Despite advances in the techniques and safety, women and patients of lower socioeconomic status continue to have worse outcomes after cardiac surgery. These persistent disparities warrant the need for root cause analysis.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Impact of Preoperative Aortic Regurgitation on Long-term Autograft Durability and Dilatation in Children and Adolescents Undergoing the Ross Procedure.
Primary aortic insufficiency (AI) is a risk factor for autograft reintervention in adults undergoing the Ross procedure. We sought to examine the influence of preoperative AI on autograft durability in children and adolescents. ⋯ Children and adolescents with AI undergoing the Ross procedure have higher rates of autograft failure. Patients with preoperative AI have more pronounced dilatation at the annulus. Akin to adults, a surgical aortic annulus stabilization technique that modulates growth is needed in children.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Empiric Flap Coverage for the Pneumonectomy Stump: How Protective Is It? A Single-Institution Cohort Study.
To evaluate the impact of empiric tissue flaps on bronchopleural fistula (BPF) rates after pneumonectomy. ⋯ Empiric bronchial stump coverage should be performed in all right pneumonectomy cases due to greater risk of BPF. In our series, intercostal muscle flaps had low BPF rates, even in right-sided operations. Coverage of the left pneumonectomy stump is unnecessary due to low incidence of BPF in these cases.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Differential expansion and outcomes of ascending and descending degenerative thoracic aortic aneurysms.
To evaluate expansion of degenerative thoracic aortic aneurysms (TAAs) and compare results between ascending and descending TAAs. ⋯ Degenerative TAAs under surveillance expand slowly. Descending TAA and larger baseline maximal aortic diameter were independently associated with more rapid TAA expansion, but these factors did not influence all-cause mortality.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Staged repair for complete atrioventricular septal defect in patients < 4.0 kg.
This study compared the mortality, left atrioventricular valve-related reoperation, and left atrioventricular valve competence in symptomatic neonates and small infants who underwent staged repair incorporating pulmonary artery banding or primary repair for complete atrioventricular septal defect. ⋯ Compared with primary repair, staged repair for complete atrioventricular septal defect in children weighing less than 4.0 kg resulted in comparable survival and reoperation rates and better left atrioventricular valve competence. Pulmonary artery banding may mitigate secondary left atrioventricular valve regurgitation unless a structural valve abnormality exists. Selective deferred intracardiac repair beyond the neonatal and small-infancy period may still play an important role in low-weight patients.