The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Multicenter StudyTreatment strategies and in-hospital mortality in patients with type A acute aortic dissection and coronary artery involvement.
Type A acute aortic dissection (AAD), especially that with coronary artery involvement and malperfusion, is a life-threatening disease. In the present study we aimed to investigate the association of surgical treatment and percutaneous coronary intervention (PCI) with in-hospital mortality in patients with type A AAD and coronary artery involvement. ⋯ Coronary artery involvement in type A AAD was associated with high in-hospital mortality of more than 40% in the current era. An early reperfusion strategy with PCI as a bridge to surgical repair might improve clinical outcomes in this fatal condition.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Randomized Controlled TrialThe impact of perioperative stroke and delirium on outcomes after surgical aortic valve replacement.
The effects of stroke and delirium on postdischarge cognition and patient-centered health outcomes after surgical aortic valve replacement (SAVR) are not well characterized. Here, we assess the impact of postoperative stroke and delirium on these health outcomes in SAVR patients at 90 days. ⋯ Stroke and delirium occur more frequently after SAVR than is commonly recognized, and these events are associated with disability, depression, cognitive decline, and poorer quality of life at 90 days postoperatively. These findings support the need for new interventions to reduce these events and improve patient-centered outcomes.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Randomized Controlled TrialRandomized Comparison of the Four-Hook Anchor Device and Hook-Wire Use for the Preoperative Localization of Pulmonary Nodules.
To compare the efficacy and safety of preoperative localization of small pulmonary nodules (SPNs) with 4-hook anchor device and hook-wire before video-assisted thoracoscopic surgery. ⋯ The use of the 4-hook anchor device for SPN localization offers advantages over the traditional hook-wire technique.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Uptake and One-Year Outcomes of Lung Transplant for COVID-19.
End-stage lung disease from severe COVID-19 infection is an increasingly common indication for lung transplantation (LT), but there are limited data on outcomes. We evaluated 1-year COVID-19 LT outcomes. ⋯ COVID-19 LT is associated with higher risk of immediate postoperative complications but similar risk of 1-year mortality despite more severe pre-LT illness. These encouraging results support the ongoing use of LT for COVID-19-related lung disease.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Robotic repair for Barlow mitral regurgitation: Repairability, safety, and durability.
In Barlow disease, increased repair complexity drives decreased repair rates. We evaluated outcomes of a simplified approach to robotic mitral repair in Barlow disease. ⋯ Barlow disease may be reliably and safely repaired with acceptable long-term durability by experienced robotic mitral surgery programs.