The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative StudyOutcomes differ in patients who undergo immediate intraoperative revision versus patients with delayed postoperative revision of residual lesions in congenital heart operations.
In a previous study of infants less than 6 month old, we found that delayed revision of residual lesions resulted in worse patient outcomes compared with intraoperative revision. We explored a larger cohort to determine if this finding persisted. ⋯ Intraoperative correction of residual lesions results in shorter length of stay, and lower postoperative AE and costs compared with delayed postoperative revision of residual lesions.
-
J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative Study Observational StudyGuidance for the use of bilateral internal thoracic arteries according to survival benefit across age groups.
Increasing evidence from observational cohort studies supports a survival advantage from bilateral internal thoracic artery (BITA) relative to single internal thoracic artery (SITA) grafts in patients undergoing coronary artery bypass grafting. Whether the survival benefit from BITA is related to patient age and any potential age cutoff for the loss of survival benefit from BITA remain to be determined. ⋯ This study provides robust scientific evidence for the loss of survival benefit from BITA for patients older than 69 years.
-
J. Thorac. Cardiovasc. Surg. · Dec 2014
Review Meta AnalysisPerformance of the European System for Cardiac Operative Risk Evaluation II: a meta-analysis of 22 studies involving 145,592 cardiac surgery procedures.
A systematic review of the European System for Cardiac Operative Risk Evaluation (euroSCORE) II performance for prediction of operative mortality after cardiac surgery has not been performed. We conducted a meta-analysis of studies based on the predictive accuracy of the euroSCORE II. ⋯ Despite the heterogeneity, the results from this meta-analysis show a good overall performance of the euroSCORE II in terms of discrimination and accuracy of model predictions for operative mortality. Validation of the euroSCORE II in prospective populations needs to be further studied for a continuous improvement of patients' risk stratification before cardiac surgery.
-
J. Thorac. Cardiovasc. Surg. · Dec 2014
Meta AnalysisLung volume reduction surgery since the National Emphysema Treatment Trial: study of Society of Thoracic Surgeons Database.
The National Emphysema Treatment Trial demonstrated that lung volume reduction surgery is an effective treatment for emphysema in select patients. With chronic lower respiratory disease being the third leading cause of death in the United States, this study sought to assess practice patterns and outcomes for lung volume reduction surgery on a national level since the National Emphysema Treatment Trial. ⋯ This study demonstrates the importance of patient selection and the need to develop consensus on appropriate benchmarks for mortality rates after lung volume reduction surgery. It underscores the need for dedicated centers to increasingly address the heavy burden of chronic lower respiratory disease in the United States in a multidisciplinary fashion, particularly for preoperative evaluation and postoperative management of emphysema.