The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Ventricular Septation for Double Inlet Ventricle: Avoiding Conduction Injury.
Although conduction location can be reliably predicted in double inlet ventricle, ventricular septation continues to carry a significant risk of complete heart block. This study describes our experience using intraoperative conduction mapping during ventricular septation. ⋯ Ventricular septation represents an alternative to the Fontan that can be performed safely in a subset of patients with acceptable early outcomes. Conduction mapping is an adjunct strategy that may add precision to well-established rules for reliably predicting conduction location.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Racial Differences in Cardiothoracic Surgery Letters of Recommendation.
Cardiothoracic surgery lacks racial diversity. Attracting the best candidates requires valuing diversity and advancing a recruitment process that minimizes racial bias. Implicit bias in recommendation letters has been identified as an influential mechanism for lack of diversity in cardiothoracic surgery. We aim to investigate how applicant race impacts language used in cardiothoracic surgery fellowship recommendation letters. ⋯ We demonstrate that authors' recommendation letters are influenced by applicant race. Letters written for White candidates are significantly longer and more descriptive of drive and outstanding characteristics than letters written for non-White candidates, particularly when written by cardiothoracic surgeons. Addressing this bias is crucial for recruiting the best candidates for cardiothoracic surgery.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
The Impact of Blood Type and Body Size on Successful Bridging to Heart Transplantation using Intraaortic Balloon Pump or Surgically Implanted Microaxial Left Ventricular Assist Device.
Waitlist time for United Network for Organ Sharing Status 2 heart transplant candidates has steadily increased. We compared a bridging strategy using either the Impella 5.0/5.5 ("Impella") or intra-aortic balloon pump with a durable left ventricular assist device in patients with blood type O stratified by body habitus. ⋯ Blood type O candidates listed with the Impella or intra-aortic balloon pump are at increased risk of postlisting mortality compared with a durable left ventricular assist device in the current organ allocation era. These effects are diminished among those with normal height and body habitus.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Do Non-fatal MACCE In The First 5-years Post CABG Affect 10-year Outcomes?
Few have examined the influence of early adverse events after coronary artery bypass grafting (CABG) on long-term survival. We sought to determine if the occurrence of nonfatal major adverse cardiac and cerebrovascular events (MACCE) during the first 5 years after CABG influences survival and adverse events at 10 years. ⋯ Patients who experienced nonfatal MACCE during the first 5 years after CABG experienced worse survival and more MACCE at 10 years. Prevention of major adverse events during the first 5 years after surgical revascularization may be an important strategy to improve late outcomes.