The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Randomized Controlled Trial Multicenter StudyFactors associated with postoperative atrial fibrillation and other adverse events after cardiac surgery.
The study objective was to evaluate the impact of various surgical characteristics and practices on the risk of postoperative atrial fibrillation and other adverse outcomes after cardiac surgery. ⋯ In this multicenter trial, we identified specific adverse outcomes that are associated with concomitant valvular and coronary artery bypass graft surgery, cardiopulmonary bypass, ventricular pacing, and occurrence of postoperative atrial fibrillation.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Multicenter StudyImprovement in TNM staging of pulmonary neuroendocrine tumors requires histology and regrouping of tumor size.
Neuroendocrine tumors of the lung are currently staged with the 7th edition TNM non-small cell lung cancer staging system. This decision, based on data analysis without data on histology or disease-specific survival, makes its applicability limited. This study proposes a specific staging system for these tumors. ⋯ Incorporating histology and regrouping tumor stage create a unique neuroendocrine tumor staging system that seems to predict survival better than the 7th TNM classification.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Comparative StudyMitral valve surgery in the US Veterans Administration health system: 10-year outcomes and trends.
To compare mitral valve repair (MVRepair) and mitral valve replacement (MVReplace) trends in the Veterans Affairs (VA) Surgical Quality Improvement Program. ⋯ In the VA Health System, mortality after MV operations is low. Despite the survival advantage associated with MV repair in primary mitral regurgitation, repair is infrequent at some centers, representing an opportunity for quality improvement.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases.
The study objective was to assess the technical and process improvement and clinical outcomes of robotic mitral valve surgery by examining the first 1000 cases performed in a tertiary care center. ⋯ Robotic mitral valve surgery is associated with a high likelihood of valve repair and low operative mortality and morbidity. The combination of algorithm-driven patient selection and increased experience enhanced clinical outcomes and procedural efficiency.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Limited root repair in acute type A aortic dissection is safe but results in increased risk of reoperation.
Management of the aortic root is a challenge for surgeons treating acute type A aortic dissection. ⋯ Limited root repair was associated with increased risk of late reoperation after repair of acute type A aortic dissection. Surgeons with adequate experience may consider aortic root replacement in well-selected patients. However, given good outcomes after limited root repair, surgeons should not feel compelled to perform this more-complex operation.