The Annals of thoracic surgery
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Multicenter Study Comparative Study
Five hundred cases of robotic totally endoscopic coronary artery bypass grafting: predictors of success and safety.
Robotic technology has enabled totally endoscopic coronary artery bypass (TECAB) grafting. Little information is available on factors associated with successful and safe performance of TECAB. We report a 10-year multicenter experience with 500 cases, elucidating on predictors of success and safety in TECAB procedures. ⋯ Single-vessel and multivessel TECAB procedures can be safely performed with good reproducible results. Predictors of success include procedure simplicity and non-learning curve cases, whereas predictors of safety are mainly associated with patient selection.
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Randomized Controlled Trial Comparative Study
Randomized trial of carpentier-edwards supraannular prosthesis versus mosaic aortic prosthesis: 6 year results.
This study prospectively compares the clinical performance of 2 stented porcine aortic bioprostheses: the Carpentier-Edwards supraannular aortic valve (CE-SAV) from Edwards Lifesciences (Irvine, CA) and the Mosaic valve from Medtronic Corp (Minneapolis, MN). We believe it is the only study of this kind. ⋯ There were no statistically significant differences in the clinical performance between CE-SAV and Mosaic aortic prostheses at 6 years after implantation.
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Multicenter Study Comparative Study
Impact of surgeon demographics and technique on outcomes after esophageal resections: a nationwide study.
Thoracic, cardiac, and general surgeons perform esophageal resections in the United States. This article examines the impact of surgeon subspecialty on outcomes after esophagectomy. ⋯ General surgeons perform the major proportion of esophagectomies in the United States. Surgeon subspecialty is not associated with the risk of complications developing but instead is associated with mortality and failure to rescue from complications. Surgeon subspecialty case mix is an important determinant of outcomes for patients undergoing esophagectomy.
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Comparative Study
Reoperation after acute type a aortic dissection repair: a series of 104 patients.
Our objective was to analyze the causes, timing, and results of reoperation after primary repair for acute type A dissection. ⋯ More extensive acute dissection repair results in a lower rate of reoperation. Mortality for redo surgery after type A acute dissection repair is acceptable. This finding should be taken into account in proposing a widespread of more complex and extensive surgery for type A acute dissection.
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Comparative Study
Blood conservation operations in pediatric cardiac patients: a paradigm shift of blood use.
Red blood cell transfusion is associated with high morbidity in pediatric patients undergoing cardiac operations. The aim of this study was to evaluate the clinical effects and outcomes of blood conservation for our pediatric patients undergoing cardiac operations. ⋯ Blood conservation in pediatric cardiac operations is associated with fewer ventilator days, lower inotropic scores, and shorter lengths of stay. These findings, in addition to attendant risks and side effects of blood transfusion and the rising cost of safer blood products, justify blood conservation in pediatric cardiac operations.