The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Late diagnosis of Marfan syndrome is associated with unplanned aortic surgery and cardiovascular death.
Marfan syndrome (MFS) guidelines recommend optimal pharmacologic therapy (OPT) and replacement of the ascending aorta (RAA) at 5.0 cm in diameter to prevent acute type A aortic dissection (ATAAD) and death. The effect of early MFS diagnosis and initiation of therapy on outcomes is not known. Therefore, we sought to evaluate the effect of age at MFS diagnosis and therapy initiation on delayed RAA and death. ⋯ Late diagnosis of MFS is associated with delayed surgery and death.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Enhanced machine learning models for predicting one-year mortality in individuals suffering from type A aortic dissection.
The study objective was to develop and validate an interpretable machine learning model to predict 1-year mortality in patients with type A aortic dissection, improving risk classification and aiding clinical decision-making. ⋯ The Treebag machine learning model effectively predicts 1-year mortality in patients with type A aortic dissection, stratifying risk profiles. Key factors for enhancing survival include surgical intervention, β-blocker administration, and management of systolic blood pressure, lymphocyte, carbon dioxide combining power, eosinophil, and white blood cell levels, offering a valuable tool for improving patient outcomes.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Laparoscopic Revisional Antireflux and Hiatal Hernia Surgery Results in a Higher Rate of Complications and Severity at 90-days Than Primary Surgery.
Data on graded complications and their frequency after laparoscopic revisional antireflux and hiatal hernia surgery compared with primary surgery are lacking. We describe 30- and 90-day morbidity using the Clavien-Dindo classification. ⋯ Revisional surgery results in similar total complications at 30 days, but additional complications can occur out to 90 days.