The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Aug 2014
Comparative StudySame-day cancellation of cardiac surgery: a retrospective review at a large academic tertiary referral center.
Same-day cancellations of cardiac surgery are unfortunate and costly occurrences that potentially place patients at risk of adverse events. ⋯ Same-day cancellation of cardiac surgery occurred infrequently (2% of cardiac operations performed) at our institution. The cancellations were for foreseeable causes in a few cases. Seeing a nonsurgeon provider more recently before cancellation was not significantly associated with nonforeseeable versus foreseeable cancellations. Although uncommon at our institution, same-day cancellations should be viewed as an opportunity for practice improvement, given the foreseeable nature of some cancelations, associated 30-day mortality, and portion of patients not subsequently undergoing cardiac surgery.
-
J. Thorac. Cardiovasc. Surg. · Aug 2014
Nationwide survey of US integrated 6-year cardiothoracic surgical residents.
Integrated 6-year cardiothoracic surgical residency programs have recently been implemented in the United States. We report the results of the first published nationwide survey assessing the motivations, satisfaction, and ambitions of integrated 6-year residents. ⋯ This survey takes an important snapshot of the nascent integrated 6-year format. Mentorship and intense clinical exposure are critical in attracting applicants. Purported advantages of the format are holding true among integrated 6-year residents, with the majority satisfied with their programs. These early data indicate that this format holds significant promise in attracting and retaining highly qualified trainees to academic cardiothoracic surgery.
-
J. Thorac. Cardiovasc. Surg. · Aug 2014
Surgical anterior ventricular endocardial restoration performed with total arterial revascularization: serial 5-year follow-up.
We evaluated the changes in left ventricular (LV) function and volumes after surgical anterior ventricular endocardial restoration. ⋯ Improved LV ejection fraction and reduced volume indexes were maintained and the stroke volume index had not decreased at 5 years after the procedure. Preserved patency of the arterial grafts might have an important role in maintaining improved LV function.
-
J. Thorac. Cardiovasc. Surg. · Aug 2014
Smoking cessation before coronary artery bypass grafting improves operative outcomes.
The detrimental effect of active smoking on operative outcome after coronary artery bypass grafting (CABG) is still debated and smoking cessation programs are usually deferred until after surgery. The potential benefit from smoking cessation on postoperative outcomes is investigated in this study. ⋯ This study showed that smoking cessation before CABG reduced the risk of serious pulmonary complications. The present findings indicate that embarking on a smoking cessation program should not be deferred until after surgery.
-
J. Thorac. Cardiovasc. Surg. · Aug 2014
The frozen elephant trunk technique for retrograde acute type A aortic dissection.
The operative strategies for retrograde acute type A aortic dissection with a primary intimal tear remain controversial because resection of an intimal tear via a median sternotomy is difficult. We evaluated the frozen elephant trunk technique for treating this type of aortic dissection. ⋯ The frozen elephant trunk technique for retrograde type A aortic dissection yielded acceptable outcomes, despite the high preoperative morbidity, and might improve the prognosis of dissection.