The Annals of thoracic surgery
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In operations for acute type A aortic dissection with open technique in elderly patients and patients with long-term treatment of anticoagulation, the transverse pericardial sinus was routinely closed before the graft implantation. With the aid of both a bovine pericardial patch covering the pericardial recess between the superior caval vein and the pulmonary artery and an opening in the left inner side of the superior caval vein, this prophylactic transverse pericardial sinus closure could make autotransfusion of blood loss into the central venous system possible to deal with the diffuse oozing from the suture line.
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Traditional journal clubs addressing single articles are limited by the lack of a standardized process for conduct and evaluation. We developed a novel, debate-style journal club for trainees to use best available evidence to address controversial topics in cardiothoracic surgery through discussion of realistic patient scenarios. ⋯ Our novel debate-style cardiothoracic surgery journal club is an effective educational intervention for cardiothoracic surgery trainees to acquire, retain, and gain practice in applying specialty-specific literature-based evidence to controversial case-based issues. Evaluation by multi-institutional expansion is needed to validate our preliminary findings in this initial trainee cohort.
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Conversion From Off-Pump Coronary Artery Bypass Grafting to On-Pump Coronary Artery Bypass Grafting.
Off-pump coronary artery bypass grafting (OPCAB) has been shown to be an effective strategy for surgical revascularization. The purpose of this study was to define the incidence of intraoperative conversion from OPCAB to on-pump coronary artery bypass grafting (ONCAB) and report outcomes based on the reason for conversion. ⋯ Intraoperative conversion from OPCAB to ONCAB remains a morbid event with a risk of mortality much higher than expected. Surgeons should consider elective ONCAB in those with a high risk for conversion during OPCAB.