The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Chronic Total Occlusions and Coronary Artery Bypass Grafting Outcomes.
Investigate the association between the presence and grafting of chronic total occlusions (CTO) and coronary artery bypass grafting (CABG) outcomes. ⋯ In this REGROUP trial subanalysis, neither CTO presence or complete grafting of CTO vessels were associated with significantly different rates of MACE. However, the finding of possible survival benefit among a subgroup of patients undergoing grafting of a dominant RCA CTO vessel alongside LAD grafting warrants additional study.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Percutaneous coronary intervention with drug-eluting stents versus coronary bypass surgery for coronary artery disease: a Bayesian perspective.
Coronary revascularization is frequently performed for coronary artery disease (CAD). This study aims to assess the totality of randomized evidence comparing percutaneous coronary intervention with drug-eluting stents (DES-PCI) to coronary artery bypass grafting (CABG) for CAD. ⋯ The current data suggests a clinically relevant benefit of CABG over DES-PCI at five years, in terms of mortality, myocardial infarction, and repeat revascularization, despite an increased risk of stroke. These findings may guide the heart-team and the shared decision-making process.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Modeling creatine-kinase MB concentrations following coronary artery bypass grafting.
An increase in cardiac biomarkers is a prerequisite to diagnose periprocedural myocardial infarction (PMI) after coronary artery bypass grafting (CABG). Early-phase risk detection may be aided by modeling time-dependent serum creatine kinase-MB (CK-MB) concentrations. This study aimed to model the kinetics of CK-MB, while identifying its influencing factors. ⋯ CK-MB release after CABG depends on the timing of measurement, sex, aortic cross-clamp time, and cardioplegia type. The model at https://www.cardiomarker.com/ckmb can be validated, reproduced, refined, and applied to other biomarkers.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Metabolomic studies reveal an organ-protective hibernation state in donor lungs preserved at 10°C.
Previous reports showed enhanced graft function in both healthy and injured porcine lungs after preservation at 10°C. The objective of the study is to elucidate the mechanism of lung protection by 10°C and identify potential therapeutic targets to improve organ preservation. ⋯ Untargeted metabolomics revealed a dynamic metabolic gradient for lungs stored at 10°C. Elucidating the underlying mechanisms behind this pathway regulation may lead to strategies that will allow organs "hibernate" for days, potentially making organ banking a reality.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
CSU-ALS Certified Centers are Associated with Improved Failure to Rescue After Cardiac Arrest: A Propensity Score Match Analysis.
The impact of Cardiac Surgical Unit - Advanced Life Support (CSU-ALS) training on failure to rescue after cardiac arrest (FTR-CA) is unknown. We hypothesized that institutional CSU-ALS certification would be associated with lower FTR-CA. ⋯ Centers with CSU-ALS certification are associated with a lower risk-adjusted likelihood of FTR after cardiac arrest. This highlights the importance of well-trained staff and treatment algorithms in the care of post-operative cardiac surgery patients.