The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Multicenter StudyOutcome of Patients supported with HeartMate 3 after Extra-corporeal Life Support. On behalf of Durable MCS after ECLS Study Group.
The Durable Mechanical Circulatory Support System After Extracorporeal Life Support registry is a multicenter registry of patients who were bridged from extracorporeal life support to a durable mechanical circulatory support system. Although numerous studies have highlighted the favorable outcomes after implantation of the HeartMate 3 (Abbott), the objective of our study is to examine the outcomes of patients who received HeartMate 3 support after extracorporeal life support. ⋯ In this critically ill patient population, the survivals of patients who were transitioned to the HeartMate 3 are deemed acceptable and superior to those observed when extracorporeal life support was bridged to other types of durable mechanical circulatory support systems.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Practice GuidelineThe American Association for Thoracic Surgery (AATS) 2024 Expert Consensus Document: Management of neonates and infants with Ebstein anomaly.
Symptomatic neonates and infants with Ebstein anomaly (EA) require complex management. A group of experts was commissioned by the American Association for Thoracic Surgery to provide a framework on this topic focusing on risk stratification and management. ⋯ Risk stratification is essential in neonates and infants with EA. Palliative comfort care may be reasonable in neonates with associated risk factors that may include prematurity, genetic syndromes, other major medical comorbidities, ventricular dysfunction, or sepsis. Neonates who are unstable with a circular shunt should have emergent interruption of the circular shunt. Neonates who are unstable are most commonly palliated with the Starnes procedure. Neonates who are stable should undergo ductal closure. Neonates who are stable with inadequate pulmonary flow may have ductal stenting or a systemic-to-pulmonary artery shunt. Subsequent procedures after Starnes palliation include either single-ventricle palliation or biventricular repair strategies.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Can Perioperative Electroencephalogram and Adverse Hemodynamic Events Predict Neurodevelopmental Outcomes in Infants with Congenital Heart Disease?
The study objective was to characterize preoperative and postoperative continuous electroencephalogram metrics and hemodynamic adverse events as predictors of neurodevelopment in congenital heart disease infants undergoing cardiac surgery. ⋯ Phenotypic patterns of perioperative continuous electroencephalogram metrics are associated with late-term neurologic injury in infants with congenital heart disease requiring surgery. Continuous electroencephalogram metrics can be integrated with hemodynamic adverse events in a predictive algorithm for neurologic impairment.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Outcomes of coronary artery obstructions after the arterial switch operation for transposition of the great arteries.
Coronary obstruction is a rare but common complication of the arterial switch operation for transposition of the great arteries. The majority of patients remain asymptomatic and no risk factors allow targeting for reinforced surveillance. We aim to review the natural history of patients diagnosed with coronary obstruction after arterial switch operation for transposition of the great arteries and occurrence of coronary-related outcomes. ⋯ Occurrence of stenosis-related events remains significant in patients after arterial switch operation, underlining the importance of early diagnosis for timely intervention. Initial anatomical evaluation identifies stenotic and at-risk patients; this will require periodical function testing. Follow-up modalities can be tailored to a patient's individual anatomic characteristics.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Randomized Controlled Trial Multicenter StudyEarly chest tube removal regardless of drainage volume after anatomic pulmonary resection: A multicenter, randomized, controlled trial.
This study aimed to evaluate the safety and feasibility of early chest tube removal after anatomic pulmonary resection, regardless of the drainage volume. ⋯ Early chest tube removal, regardless of drainage volume, was safe and feasible in patients who underwent anatomic pulmonary resection.