The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Randomized Controlled Trial Comparative StudyTissue-based coronary surgery simulation: medical student deliberate practice can achieve equivalency to senior surgery residents.
The study objective was to assess the impact of dedicated instruction and deliberate practice on fourth-year medical students' proficiency in performing a coronary anastomosis using a porcine heart model, compared with nonsimulator-trained senior general surgery residents. ⋯ Dedicated instruction of fourth-year medical students with deliberate and distributed practice of microvascular techniques using a porcine end-to-side coronary artery anastomosis simulation model results in performance comparable to that of senior general surgery residents. These results suggest that focused tissue simulator training can compress the learning curve to acquire technical proficiency in comparison with real-time training.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Clinical impact of neurocognitive deficits after cardiac surgery.
Postoperative neurocognitive deficits (POCDs) have been found to occur frequently after cardiac surgery. Although POCDs have received significant attention in the medical literature and public media, the true clinical impact of these deficits on patient outcomes and quality of life (QOL) is not well defined. ⋯ Neurocognitive deficits can be frequently detected on comprehensive neuropsychometric testing after cardiac surgery. However, they are not associated with any clinically important differences in patient outcome or in QOL after surgery.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Predictors of conversion to thoracotomy for video-assisted thoracoscopic lobectomy: a retrospective analysis and the influence of computed tomography-based calcification assessment.
Conversion to an open thoracotomy during video-assisted thoracoscopic surgery lobectomy is reported to occur in up to 23% of cases and can be associated with increased morbidity. We developed a preoperative computed tomography calcification score based on anatomic location and extent of calcifications to evaluate the ability to predict video-assisted thoracoscopic surgery conversion. ⋯ Calcification score based on the location and degree of calcifications can predict the increased likelihood of video-assisted thoracoscopic surgery conversion. This scoring system could be one element used to choose the approach for a lobectomy, especially during a surgeon's learning curve.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Controlled Clinical TrialApplication of bronchoscopic argon plasma coagulation in the treatment of tumorous endobronchial tuberculosis: historical controlled trial.
The purpose of this study was to evaluate the efficacy and safety of bronchoscopic argon plasma coagulation for tumorous endobronchial tuberculosis. ⋯ Bronchoscopic argon plasma coagulation can accelerate the healing of tumorous endobronchial tuberculosis and can help prevent progressive bronchial stenosis resulting from tumorous endobronchial tuberculosis, and it is a very safe method.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Comparative StudyEarly and long-term outcomes of coronary artery bypass grafting in patients with acute coronary syndrome versus stable angina pectoris.
The aim of the present study was to determine the early and long-term outcomes of coronary artery bypass grafting in patients with acute coronary syndrome and stable angina pectoris. ⋯ Although acute coronary syndrome is an independent predictor of early mortality in patients undergoing coronary artery bypass grafting, the long-term outcomes after surgery were similar between patients with acute coronary syndrome and stable angina pectoris who survived the early postoperative period.