The Annals of thoracic surgery
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It is important to characterize in-hospital mortality after cardiac surgery and understand the relationships between postoperative length of intensive care unit stay, postoperative length of hospital stay, and the likelihood of in-hospital mortality. ⋯ Most in-hospital mortality occurs during the first week after cardiac surgery with few mortalities occurring after a protracted hospital course. Postoperative complications have a limited ability to explain the variability in mortality timing. Increased length of postoperative intensive care unit stay and hospital stay after cardiac surgery are associated with an increased likelihood of in-hospital mortality.
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Meta Analysis Comparative Study
Comparison of graft patency between off-pump and on-pump coronary artery bypass grafting: an updated meta-analysis.
Currently, off-pump coronary artery bypass grafting (OPCAB) and on-pump coronary artery bypass grafting (ONCAB) are 2 well-established therapeutic strategies for patients with coronary artery disease, and debate regarding which strategy provides superior graft patency is ongoing. The current study is a meta-analysis of randomized controlled trials that compared the graft patency between OPCAB and ONCAB. ⋯ Meta-analysis of currently available randomized controlled trials on graft patency shows that ONCAB reduces the incidence of SVG graft occlusion significantly but does not affect LIMA and radial artery graft patency compared with OPCAB.
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Comparative Study
Root stabilization of the repaired bicuspid aortic valve: subcommissural annuloplasty versus root reimplantation.
At our institution, type I bicuspid aortic valve (BAV) patients with aortic insufficiency (AI) who are candidates for valve preservation are stratified into two groups by aortic root pathology: nonaneurysmal root undergoing primary cusp repair+subcommissural annuloplasty (repair group) vs aneurysmal root undergoing primary cusp repair+root reimplantation (reimplantation group). We report outcomes of this surgical reconstructive strategy for the repaired type I BAV. ⋯ Root stabilization with the reimplantation technique significantly improves the durability of the repaired type I BAV compared with subcommissural annuloplasty. It also provides improved and sustained valve mobility (transvalvular gradients).
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Valve-sparing aortic root replacement (VSARR) is an alternative to traditional composite valve graft (CVG) root replacement. We examined early and midterm outcomes after VSARR. ⋯ Valve-sparing aortic root replacement can have excellent early and respectable midterm outcomes, even when combined with arch repair. Further follow-up remains necessary to evaluate the long-term durability of VSARR.
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Fluorodeoxyglucose-positron emission tomography (FDG-PET) is recommended for diagnosis and staging of non-small cell lung cancer (NSCLC). Meta-analyses of FDG-PET diagnostic accuracy demonstrated sensitivity of 96% and specificity of 78% but were performed in select centers, introducing potential bias. This study evaluates the accuracy of FDG-PET to diagnose NSCLC and examines differences across enrolling sites in the national American College of Surgeons Oncology Group (ACOSOG) Z4031 trial. ⋯ In a national surgical population with clinical stage I NSCLC, FDG-PET to diagnose lung cancer performed poorly compared with published studies.