The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Introducing transapical aortic valve implantation (part 2): institutional structured training program.
Introduction of a new procedure has a typical learning curve with the "learning phase" at the beginning, characterized by an increased mortality or complication rate. We developed our institutional structured training program for transcatheter aortic valve implantation (TAVI) with the aim of eliminating these negative effects. ⋯ A structured educational training program enables implementation of a new procedure (TAVI) into clinical practice without increased morbidity and mortality rate during the learning curve. The program may also be used as a basis for any new device introduction into clinical practice.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Time in the stair-climbing test as a predictor of thoracotomy postoperative complications.
The stair-climbing test as measured in meters or number of steps has been proposed to predict the risk of postoperative complications. The study objective was to determine whether the stair-climbing time can predict the risk of postoperative complications. ⋯ The only variable showing association with complications, according to multivariate analysis, was stair-climbing time.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Quantifying the incidence and impact of postoperative prolonged alveolar air leak after pulmonary resection.
Prolonged alveolar air leak (PAAL) is a frequent occurrence after lobectomy or lesser resections. The resulting complications and their impact are not well understood. Our aims are to prospectively determine the incidence and severity of PAAL after pulmonary resection using the Thoracic Morbidity & Mortality classification system and to identify risk factors. ⋯ PAAL leads to longer hospital stays, and approximately 4.8% of patients undergoing pulmonary resection experience PAAL that necessitates placement of additional chest drains, bronchoscopy, reoperation, or life support. Further study is required to assess the cost-effectiveness of measures to reduce PAAL.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Predictors of hyperglycemia after cardiac surgery in nondiabetic patients.
Postoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing cardiac surgery. However, some experts consider hyperglycemia to be an epiphenomenon related to acute stress. We investigated whether preoperative patient characteristics can predict hyperglycemia after cardiac surgery in nondiabetic patients. ⋯ Preoperative patient characteristics are associated with hyperglycemia after cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Clinical TrialClinical analysis of concomitant valve replacement and bipolar radiofrequency ablation in 191 patients.
The study objective was to evaluate the safety and efficacy of concomitant bipolar radiofrequency ablation and heart valve replacement in patients with rheumatic heart disease and atrial fibrillation. ⋯ Concomitant bipolar radiofrequency ablation is an effective and safe technique for treating atrial fibrillation in patients with rheumatic heart disease undergoing valve replacement, with promising follow-up results.