The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2014
ReviewTranscatheter aortic valve replacement in patients with severe aortic stenosis who are at high risk for surgical complications: summary assessment of the California Technology Assessment Forum.
The California Technology Assessment Forum is dedicated to assessment and public reporting of syntheses of available data on medical technologies. In this assessment, transcatheter aortic valve replacement (TAVR) was evaluated for patients with severe aortic stenosis (AS) who are at high risk for complications. ⋯ TAVR is a potentially lifesaving procedure that may improve quality of life for patients at high risk for surgical AVR. However, attention needs to be paid to appropriate patient selection, their preoperative evaluation, surgical techniques, and postoperative care to preserve and improve on the results attained in the Placement of Aortic Transcatheter Valve trial. Specialty societies are collaborating to ensure that this happens in a rational and comprehensive manner.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Blood transfusions are associated with urinary biomarkers of kidney injury in cardiac surgery.
Cardiac surgery is a major cause of acute kidney injury. In this setting, receipt of blood transfusions seems to be associated with a higher risk of acute kidney injury, as measured using serum creatinine values. We examined this association further by using urinary biomarkers of kidney injury. ⋯ Receipt of 2 or more packed red blood cell units during cardiac surgery is associated with a greater risk of acute kidney injury defined by serum creatinine and kidney injury biomarkers.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: a 9-year, single-center experience.
Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients. ⋯ The statistically significant predictors for SR after 1 year were left atrial diameter, AF duration, preoperative paroxysmal AF, immediate postoperative SR, and biatrial ablation for persistent AF.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Comparative StudyFewer complications result from a video-assisted approach to anatomic resection of clinical stage I lung cancer.
Anatomic resection is currently the standard of care for clinical stage I lung cancer, yet clinicians increasingly pursue nonsurgical, ablative therapies to avoid the morbidity of thoracotomy. The video-assisted thoracic surgery (VATS) approach is a minimally invasive alternative to thoracotomy yet the effect of VATS on the morbidity of patients undergoing lung cancer resection is not fully characterized. We evaluated complications following anatomic resection of clinical stage I lung cancer by VATS and thoracotomy to clarify the effect of the minimally invasive approach. ⋯ Anatomic resection of early stage lung cancer is performed with a low mortality rate, according to data from the Society of Thoracic Surgeons database. Perioperative complications are significantly less likely to occur when patients with stage I lung cancers undergo resection using the VATS approach. Further study is warranted to determine long-term effects of these differences in perioperative outcomes.