The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Distal aortic progression following acute type A aortic dissection repair among patients with bicuspid and tricuspid aortic valves.
The study objective was to analyze long-term growth and outcomes of the distal aorta after open acute type A aortic dissection repair in patients with bicuspid aortic valves or tricuspid aortic valves without connective tissue disease. ⋯ Patients with bicuspid aortic valves could be treated similarly as patients with tricuspid aortic valves without connective tissue disease in the setting of open acute type A aortic dissection repair.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Comparative StudyVariability and relative contribution of surgeon and anesthesia specific time components to total procedural time in cardiac surgery.
Decreasing variability in time-intensive tasks during cardiac surgery may reduce total procedural time, lower costs, reduce clinician burnout, and improve patient access. The relative contribution and variability of surgeon control time (SCT) and anesthesia control time (ACT) to total procedural time is unknown. ⋯ SCT variability is significantly greater than ACT variability and is strongly associated with the surgeon performing the procedure. Although these results suggest that SCT variability is an attractive operational target, further studies are needed to determine practitioner specific and modifiable attributes to reduce variability and improve efficiency.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Observational StudyCerebral Autoregulation monitoring using Cerebral Oximetry index after neonatal cardiac surgery: a single-center retrospective cohort study.
To investigate whether cerebral autoregulation is impaired after neonatal cardiac surgery and whether changes in autoregulation metrics are associated with different congenital heart defects or the incidence of postoperative neurologic events. ⋯ COx monitoring after cardiac surgery allowed for the detection of impaired cerebral autoregulation, which was more frequent in neonates with postoperative acute neurologic events.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Outcomes of Quantitative Flow Ratio Based Functional Incomplete Revascularization after Coronary Artery Bypass Grafting Surgery.
Quantitative flow ratio is a novel functional assessment tool of coronary diseases. Whether quantitative flow ratio could improve the outcomes of coronary artery bypass grafting is undetermined. This study aimed to investigate the association between the quantitative flow ratio based functional incomplete revascularization and the outcomes after coronary artery bypass grafting surgery. ⋯ Both the functional incomplete revascularization and anatomic incomplete revascularization were associated with increased risks of 12-month major adverse cardiac or cerebral vascular events after coronary artery bypass grafting surgery. The quantitative flow ratio can serve as a supplementary tool for the decision-making of surgical revascularization.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Can Perioperative Electroencephalogram and Adverse Hemodynamic Events Predict Neurodevelopmental Outcomes in Infants with Congenital Heart Disease?
The study objective was to characterize preoperative and postoperative continuous electroencephalogram metrics and hemodynamic adverse events as predictors of neurodevelopment in congenital heart disease infants undergoing cardiac surgery. ⋯ Phenotypic patterns of perioperative continuous electroencephalogram metrics are associated with late-term neurologic injury in infants with congenital heart disease requiring surgery. Continuous electroencephalogram metrics can be integrated with hemodynamic adverse events in a predictive algorithm for neurologic impairment.