The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2011
Cardiovascular surgery risk prediction from the patient's perspective.
Previous studies have developed cardiovascular surgery outcome prediction models using only patient risk factors, but surgery outcomes from the patient's perspective seem to differ between hospitals. We have developed outcome prediction models that incorporate preoperative patient risks, as well as hospital processes and structure. ⋯ Our models yielded good discrimination and calibration, so they may prove useful for hospital selection based on individual patient risks and circumstances. Improved surgeon work environments were also shown to be important for both surgeons and patients.
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J. Thorac. Cardiovasc. Surg. · Aug 2011
Long-term follow-up of acute type B aortic dissection: ulcer-like projections in thrombosed false lumen play a role in late aortic events.
Patients with Stanford type B dissection treated medically during the acute phase have a risk of surgery and aortic rupture during the chronic phase. We investigated the predictors for late aortic events by focusing on the false lumen status with computed tomography. ⋯ In type B aortic dissection, a thrombosed false lumen with ulcer-like projections and a patent false lumen had an influence on late aortic dilation and late aortic events.
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J. Thorac. Cardiovasc. Surg. · Aug 2011
Meta Analysis Comparative StudyNeurologic complications after off-pump coronary artery bypass grafting with and without aortic manipulation: meta-analysis of 11,398 cases from 8 studies.
Neurologic complications after coronary artery bypass grafting remain a concern. Off-pump coronary artery bypass grafting is a surgical strategy proposed to decrease this risk. Use of an off-pump anaortic technique, which leaves the ascending aorta untouched, may result in further reductions. This systematic review of all published evidence compares neurologic complications after anaortic off-pump coronary artery bypass grafting versus that with aortic manipulation. ⋯ Avoidance of aortic manipulation during off-pump coronary artery bypass grafting decreases neurologic complications relative to standard technique in which the ascending aorta is manipulated. In patients at high risk for stroke or transient ischemic attack, we recommend avoidance of aortic manipulation during off-pump coronary artery bypass grafting.