The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2022
Undersizing mitral annuloplasty alters left ventricular mechanics in a swine model of ischemic mitral regurgitation.
Undersizing mitral annuloplasty (UMA) is a frequently used surgical repair technique to correct ischemic mitral regurgitation in patients with heart failure. In this study, we sought to test the hypothesis that downsizing the mitral annulus can adversely affect the shape and mechanics of the left ventricle inhibiting its functional recovery. ⋯ Undersizing the mitral annulus with an annuloplasty ring can restore valvular competence, but unphysiologically impair ventricle mechanics. Mitral valve repair strategies should focus not only on restoring valve competence, but preserving ventricle mechanics.
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J. Thorac. Cardiovasc. Surg. · Sep 2022
Unraveling the impact of time-dependent perioperative variables on 30-day readmission after coronary artery bypass surgery.
Readmission within 30 days of discharge after coronary artery bypass grafting is a measure of quality and a driver of cost in health care. Traditional predictive models use time-independent variables. We developed a new model to predict time to readmission after coronary artery bypass grafting using both time-independent and time-dependent preoperative and perioperative data. ⋯ Time-dependent perioperative variables in an isolated coronary artery bypass grafting cohort provided better predictive ability to a readmission model. This study was unique in the inclusion of time-dependent covariates in the predictive model for readmission after discharge after coronary artery bypass grafting.
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J. Thorac. Cardiovasc. Surg. · Sep 2022
Long-term patient-reported outcomes after non-small cell lung cancer resection.
Patient-reported outcomes (PROs) are critical tools for evaluating patients before and after lung cancer resection. In this study, we assessed patient-reported pain, dyspnea, and functional status up to 1 year postoperatively. ⋯ PROs are important metrics for assessing patients before and after lung cancer resection. Patients may report persistent dyspnea up to 1 year after resection. Additionally, patients undergoing thoracotomy initially report worse pain and physical function but these impairments improve by 6 months after surgery.
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J. Thorac. Cardiovasc. Surg. · Sep 2022
A multiparameter algorithm to guide repair of degenerative mitral regurgitation.
Degenerative mitral regurgitation repair using a measured algorithm could increase the precision and reproducibility of repair outcomes. ⋯ A simple, reproducible, measured algorithm for degenerative mitral valve repair provides excellent early and late results and is a useful adjunct to established surgical techniques.
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J. Thorac. Cardiovasc. Surg. · Sep 2022
The Ross procedure in patients older than 50: A sensible proposition?
The Ross procedure offers several advantages in nonelderly adults; however, the optimal age cutoff remains undetermined. The aim of this study was to compare the safety and mid-term outcomes after the Ross procedure in adult patients age ≤50 years and those age >50 years. ⋯ The Ross procedure is a safe operation in patients age >50 years and provides excellent hemodynamics, stable valve function, and restored survival at mid-term follow-up. In expert centers, it should be considered as an alternative in selected patients age >50 years.