The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Sep 2024
Increasing Surgeon Experience and Cumulative Institutional Experience Drive Decreasing Hospital Mortality after Reoperative Cardiac Surgery.
The study objective was to identify the effects of surgeon experience and age, in the context of cumulative institutional experience, on risk-adjusted hospital mortality after cardiac reoperations. ⋯ Surgeon age and experience have been implicated in adverse surgical outcomes, particularly after complex cardiac operations, with young surgeons being novices and older surgeons having declining ability. However, at Cleveland Clinic, outcomes of cardiac reoperations improved with increasing primary surgeon experience, without any suggestion to mid-70s of an age cutoff. Patients were protected by the cumulative background of institutional experience that created a culture of safety and teamwork that mitigated adverse events after cardiac surgery.
-
J. Thorac. Cardiovasc. Surg. · Sep 2024
Multicenter StudyLong-Term Results Of Atrial Fibrillation Surgery Concomitant With Mitral Valve Surgery: A Propensity Score-Matched Multicenter Study.
The aim of the study was to elucidate the long-term outcomes of atrial fibrillation surgery in patients with atrial fibrillation and mitral valve disease by comparing the patients who underwent mitral valve surgery with and without atrial fibrillation surgery. ⋯ In patients with atrial fibrillation and mitral valve disease, mitral valve surgery concomitant with atrial fibrillation surgery was associated with lower mortality, cardiac mortality, major adverse cardiac and cerebrovascular events, and stroke or transient ischemic attack up to 15 years after surgery when compared with mitral valve surgery without atrial fibrillation surgery.
-
J. Thorac. Cardiovasc. Surg. · Sep 2024
Multicenter StudySeven-Year Outcomes Following Aortic Valve Replacement with a Novel Tissue Bioprosthesis.
As bioprosthetic aortic valve replacement (AVR) extends to younger cohorts, tissue durability is of paramount importance. We report 7-year outcomes from an AVR bioprosthesis utilizing novel tissue. ⋯ We report the longest surgical AVR follow-up with novel tissue in an investigational device exemption trial utilizing an independent clinical events committee and an echocardiography core laboratory. This tissue demonstrates excellent outcomes through 7 years and is the benchmark for future surgical and transcatheter prostheses.
-
J. Thorac. Cardiovasc. Surg. · Sep 2024
Comparative StudyCoronary Artery Bypass Surgery vs. Percutaneous Interventions for Women with Multivessel Coronary Artery Disease.
To compare outcomes in women undergoing percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery. ⋯ For women with multivessel coronary artery disease, CABG surgery is associated with lower 6-year mortality, myocardial infarction, and repeat revascularization rates compared to PCI with EES.
-
J. Thorac. Cardiovasc. Surg. · Sep 2024
Thirty years of surgical management of pediatric pulmonary hypertension :mid-term outcomes following reverse Potts shunt and transplantation.
Reverse Potts shunt (RPS) and lung or heart-lung transplantation are life-extending surgical interventions for pediatric patients with severe pulmonary arterial hypertension (PAH). Robust criteria for identifying patients who will benefit from these procedures remain elusive. Based on 30 years of experience, we sought to refine the surgical indications. ⋯ In selected children with suprasystemic PAH, RPS is associated with functional capacity improvements and decreased pharmacotherapy needs over the midterm. RPS deserves consideration earlier in the course of pediatric PAH, with transplantation being performed in the event of refractory RV failure.