The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Jun 2023
Outcomes of endovascular therapy for Stanford type B aortic dissection in patients with Marfan syndrome.
To evaluate the mid-term outcomes of thoracic endovascular aorta repair (TEVAR) for Stanford type B aortic dissection (TBAD) in patients with Marfan syndrome (MFS). ⋯ TEVAR can be performed safely and effectively for TBAD in patients with MFS. Perioperative mortality and morbidity were low; however, lifelong close follow-up in the clinic and imaging are mandatory to prevent aortic rupture. Patients with a patent FL were at high risk of late death.
-
J. Thorac. Cardiovasc. Surg. · Jun 2023
Analysis of the revised heart allocation policy and the influence of increased mechanical circulatory support on survival.
In 2018, the new United Network for Organ Sharing heart allocation policy took effect. This study evaluated waitlist mortality, mechanical circulatory support utilization, and its influence on posttransplant survival. ⋯ The United Network for Organ Sharing policy change is associated with reduced waitlist mortality and similar risk adjusted posttransplant 180-day mortality. The new era is also associated with improved 180-day survival in patients undergoing bridge to transplant with extracorporeal membrane oxygenation.
-
J. Thorac. Cardiovasc. Surg. · Jun 2023
Effect of sarcopenia on survival and spinal cord deficit outcomes after thoracoabdominal aortic aneurysm repair in patients 60 years of age and older.
Sarcopenia (core muscle loss) has been used as a surrogate marker of frailty. We investigated whether sarcopenia would adversely affect survival after thoracoabdominal aortic aneurysm repair. ⋯ Sarcopenia did not influence early mortality or midterm survival after thoracoabdominal aortic aneurysm repair but was associated with greater risk for delayed and persistent paraplegia.
-
J. Thorac. Cardiovasc. Surg. · Jun 2023
When a segmentectomy is not a segmentectomy: Quality assurance audit and evaluation of required elements for an anatomic segmentectomy.
The advent of lung cancer screening and detection of smaller nodules amplifies the need to clarify the oncological quality of sublobar resections. Furthermore, studies comparing sublobar resections to lobectomies offer conflicting conclusions. We hypothesize that this is driven, in part, by inconsistency in reporting; that is, variable interpretation of what constitutes an operative segment. Without an established standard, 2 very different operations may be reported as segmental resections, leaving the data on sublobar approaches subject to interpretative variability. ⋯ Nearly 20% of reported segmentectomies may not meet criteria for true segmental resection. Therefore, prior studies may need further scrutiny to clarify outcomes and results. Establishing a professional standard may help mitigate ambiguity in published data on this subject.
-
J. Thorac. Cardiovasc. Surg. · Jun 2023
Comprehensive assessment of heart failure in patients with preserved ejection fraction undergoing coronary bypass grafting.
Although coronary artery bypass grafting is expected to improve the outcomes of patients with advanced coronary artery disease, whether prognosis is different according to preoperative diastolic function remains unclear. This study sought to evaluate the prognostic implications of preoperative heart failure with preserved ejection fraction in patients undergoing coronary artery bypass grafting. ⋯ On the basis of noninvasive assessment using Heart Failure Association Pretest Assessment, Echocardiography and Natriuretic Peptide, Functional Testing, Final Etiology score, a substantial proportion of patients with coronary artery disease who underwent coronary artery bypass grafting had preoperative heart failure with preserved ejection fraction. Preoperative heart failure with preserved ejection fraction was significantly associated with a decrease in the 5-year survival after successful coronary artery bypass grafting.