The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Clinical features and postoperative outcomes in elderly patients undergoing septal myectomy for hypertrophic cardiomyopathy.
Surgical septal reduction is sometimes avoided in older adults due to anticipated high operative risk. The study objectives were to compare the clinical and echocardiographic characteristics of young and older patients undergoing septal myectomy for obstructive hypertrophic cardiomyopathy and assess differences in early and late postoperative outcomes. ⋯ Clinical characteristics of obstructive hypertrophic cardiomyopathy in older patients differ from those in younger patients. More symmetric but less extensive ventricular hypertrophy and less positive genetic testing suggests that hypertrophic cardiomyopathy has distinct clinical and morphological variants in the elderly. Septal myectomy is safe in older patients, but the presence of left ventricular wall asymmetry portends a poorer prognosis.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
The Impact of the American Association of Thoracic Surgery on Clinical Trial Development by Cardiothoracic Surgeons.
Clinical trials play a critical role in the rapidly evolving field of cardiothoracic surgery and the American Association for Thoracic Surgery Clinical Trials Methods Course has provided a biannual symposium led by preeminent surgeons with vast experience in planning, conducting, and analyzing surgical clinical trials. This study hypothesizes that participation in the course is associated with future success in clinical trial leadership. ⋯ The American Association for Thoracic Surgery Clinical Trials Methods course provides participants the tools for successfully leading surgical clinical trials. Although participation has been limited, those who attend the course and lead a clinical trial do so within approximately 3 years. The Clinical Trials Methods Course provides an excellent return on investment and the American Association for Thoracic Surgery should continue sponsorship of this program because it supports the develop of future leaders in cardiothoracic surgery.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Strategic Implementation of a New Robotic Mitral Repair Program: Early Experience and Outcomes.
Despite numerous reported benefits of robotic mitral repair, the absolute number of procedures performed remain low in part to uncertainties about the necessary steps to launch a program. In this report, we describe our early outcomes and strategy with launching a successful new robotic mitral repair program. ⋯ Our work provides a model for establishing a successful robotic mitral program. An up-front emphasis on team education, careful preparation, proper patient selection, and feedback-driven improvements can accelerate the attainment of standards set by high-volume centers.