The Annals of thoracic surgery
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Case Reports
Ascending Aortic Replacement and Sutureless Valve in a Failed Stentless Aortic Prosthesis: A Bailout Option.
Aortic valve replacement with a Perceval sutureless bioprosthesis is a viable rescue option for a failed aortic stentless prosthesis. However, a dilated sinotubular junction and ascending aorta are reported as a contraindication for this technique. We describe an aortic sutureless valve implantation in a patient with a dilated ascending aorta and small aortic root after Dacron graft replacement of the ascending aorta in a failed aortic stentless bioprosthesis.
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The art and science of outcomes analysis, quality improvement, and patient safety continue to evolve, and cardiothoracic surgery leads many of these advances. The Society of Thoracic Surgeons (STS) National Database is one of the principal reasons for this leadership role, as it provides a platform for the generation of knowledge in all of these domains. ⋯ Therefore, beginning in January 2016, The Annals of Thoracic Surgery began publishing a monthly series of scholarly articles on outcomes analysis, quality improvement, and patient safety. This article provides a summary of the status of the STS National Database as of October 2016 and summarizes the articles about the STS National Database that appeared in The Annals of Thoracic Surgery 2016 series, "Outcomes Analysis, Quality Improvement, and Patient Safety."
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The Society of Thoracic Surgeons General Thoracic Surgery Database has grown to more than 500,000 case records. Clinical research supported by the database is increasingly used to advance patient outcomes. This research review from the General Thoracic Surgery Database in 2014 and 2015 discusses 6 recent publications and an ongoing study on longitudinal outcomes in lung cancer surgery from The Society of Thoracic Surgeons Task Force for Linked Registries and Longitudinal Follow-up. A lack of database variables specific for certain uncommon procedures limits the ability to study these operations; inclusion of clinical descriptors for selected infrequent but clinically important thoracic disorders is suggested.
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Comparative Study
Stent Grafting Acute Aortic Dissection: Comparison of DeBakey Extent IIIA Versus IIIB.
Thoracic endovascular aortic repair (TEVAR) with stent grafting is effective for acute dissection in selected patients, but most remain at risk for reintervention. The effect of the extent of dissection on outcome is unclear. Objectives of this study were to compare characteristics, outcomes, and aortic remodeling after TEVAR between patients with DeBakey extent IIIA and IIIB dissection. ⋯ In patients requiring TEVAR for acute dissection, patient factors and aortic morphology differ by the extent of the dissection. Aortic remodeling after TEVAR was better in patients with limited extent (IIIA) dissection than in than patients with extensive (IIIB) dissection. Despite these differences, very little difference was noted in early and late outcomes, which may be explained by differences in patient characteristics.