The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2024
A Novel Hybrid Prosthesis for Open Repair of Acute DeBakey Type I Dissection with Malperfusion: Early Results from the PERSEVERE Trial.
Outcomes after hemiarch repair for acute DeBakey type I aortic dissection (ADTI) remain unfavorable, with high rates of major adverse events and negative aortic remodeling. The PERSEVERE study evaluates the safety and effectiveness of the AMDS Hybrid prosthesis, a novel bare metal stent, in patients presenting with preoperative malperfusion. ⋯ Early results show significant reductions in major adverse events and distal anastomotic new entry tears, successfully meeting both primary endpoints. The technical success rate was high. AMDS can be used safely in patients with ADTI dissection with malperfusion.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
American Association for Thoracic Surgery Quality Gateway: A Surgeon Case Study of Its Application in Adult Cardiac Surgery for Quality Assurance.
To demonstrate the application of American Association for Thoracic Surgery Quality Gateway (AQG) outcomes models to a Surgeon Case Study of quality assurance in adult cardiac surgery. ⋯ Using minimal data collection and models developed using advanced machine learning, this case study shows that probabilities can be generated for operative mortality and major morbidity after virtually all adult cardiac operations. It demonstrates the utility of 21st century causal inference (virtual [digital] twin) tools for assessing quality for surgeons asking "how am I doing?," their patients asking "what are my chances?," and the profession asking "how can we get better?"
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Survival, Function, and Immune Profiling after Beating Heart Transplantation.
Ex vivo normothermic perfusion of cardiac allografts has expanded the donor pool for heart transplant. Using a beating heart implantation method avoids the second cardioplegic arrest and subsequent ischemia-reperfusion injury typically associated with ex vivo heart perfusion. We sought to describe our institutional experience with beating heart transplantation. ⋯ A beating heart implantation technique can be used for transplantation of DCD and DBD hearts on EVHP and is associated with excellent survival and low levels of rejection.