The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Does new-onset postoperative atrial fibrillation after coronary artery bypass grafting affect postoperative quality of life?
New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. We investigated the effect of POAF on quality of life after coronary artery bypass grafting. ⋯ New-onset POAF does affect 6-month postoperative mental and physical health, possibly warranting more aggressive POAF treatment.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Temporary right ventricular mechanical circulatory support for the management of right ventricular failure in critically ill patients.
Management of right ventricular (RV) failure after left ventricular assist device (LVAD) implantation is not evidence based. Temporary circulatory assistance has recently been reported to be of value for managing postoperative RV failure after LVAD implantation, but only in small series of patients or isolated case reports. We report here our experience with the use of temporary right ventricular assist devices (RVADs) in LVAD recipients. ⋯ The development of RV failure in LVAD recipients is a serious problem associated with high mortality. Temporary RV mechanical support is an acceptable way to manage postoperative RV failure in these severely ill LVAD recipients.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Mild postoperative acute kidney injury and outcomes after surgery for congenital heart disease.
The effect of mild acute kidney injury (AKI) on outcomes after heart surgery in children is unclear. We sought to characterize the epidemiology of mild AKI associated with surgery for congenital heart disease (CHS-AKI) in children. ⋯ AKI occurs after surgery for congenital heart disease but may be less common than previously reported. Although moderate to severe CHS-AKI is independently associated with prolonged recovery after heart surgery, mild disease does not appear to be.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Identifying predictors of hepatic disease in patients after the Fontan operation: a postmortem analysis.
We characterized the histologic liver changes that occur after the Fontan operation and identified the factors associated with worsening hepatic disease. ⋯ The interval from the initial Fontan operation to death is associated with increased sinusoidal and portal fibrosis. In this small cohort, older age at Fontan operation was associated with sinusoidal fibrosis. Significant sinusoidal fibrosis was observed in patients who died early after the Fontan operation, with more severe disease present in patients with heterotaxy syndrome.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Do tumor location and grade affect survival in pT2N0M0 esophageal squamous cell carcinoma?
The TNM staging system for esophageal cancer in the seventh edition of the AJCC Cancer Staging Manual incorporates tumor grade and location for staging pT2-3N0M0 esophageal squamous cell carcinoma. Patients with pT2N0M0, classified as stage IIA according to the sixth edition of the AJCC Cancer Staging Manual, can now be classified as stage IB, IIA, or IIB. We discuss whether these changes lead to a better prediction of the prognosis of these patients and aimed to find out other factors to forecast patient prognosis. ⋯ For pT2N0M0 esophageal squamous cell carcinoma, the seventh edition of the AJCC Cancer Staging Manual does not provide a more distinguishable prediction of prognosis compared with the sixth edition. Tumor grade is an independent prognostic factor in patients with pT2N0M0 esophageal squamous cell carcinoma, whereas tumor location is not. Furthermore, alcohol consumption is an independent prognostic factor that may imply a worse prognosis.