The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Blood transfusions are associated with urinary biomarkers of kidney injury in cardiac surgery.
Cardiac surgery is a major cause of acute kidney injury. In this setting, receipt of blood transfusions seems to be associated with a higher risk of acute kidney injury, as measured using serum creatinine values. We examined this association further by using urinary biomarkers of kidney injury. ⋯ Receipt of 2 or more packed red blood cell units during cardiac surgery is associated with a greater risk of acute kidney injury defined by serum creatinine and kidney injury biomarkers.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Observational StudyPostoperative complications and association with outcomes in pediatric cardiac surgery.
Our primary aim was to study postoperative complications in pediatric cardiac surgery patients and their association with cardiopulmonary bypass (CPB) use. The secondary aim was to evaluate the association of postoperative complications with established outcome measures. ⋯ Postoperative complications occurred in 43% of pediatric cardiac surgeries performed both with and without CPB. The complications were associated with longer mechanical ventilation and pediatric cardiac intensive care unit and hospital stays, and increased mortality.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Harvesting bilateral internal thoracic arteries using a novel subxiphoid approach versus the conventional lateral thoracic approach--results of an experimental study.
A new method was developed to harvest bilateral internal thoracic artery grafts using a subxiphoid approach and robotic assistance. The present study compared the potential utility of the subxiphoid method with that of the lateral thoracic approach. ⋯ Because of the maximized lengths of the grafts and the duration of the procedure, the robot-assisted subxiphoid approach could be an effective method for performing minimally invasive myocardial revascularization in patients with multivessel disease.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Comparative StudySame-day cancellation of cardiac surgery: a retrospective review at a large academic tertiary referral center.
Same-day cancellations of cardiac surgery are unfortunate and costly occurrences that potentially place patients at risk of adverse events. ⋯ Same-day cancellation of cardiac surgery occurred infrequently (2% of cardiac operations performed) at our institution. The cancellations were for foreseeable causes in a few cases. Seeing a nonsurgeon provider more recently before cancellation was not significantly associated with nonforeseeable versus foreseeable cancellations. Although uncommon at our institution, same-day cancellations should be viewed as an opportunity for practice improvement, given the foreseeable nature of some cancelations, associated 30-day mortality, and portion of patients not subsequently undergoing cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: a 9-year, single-center experience.
Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients. ⋯ The statistically significant predictors for SR after 1 year were left atrial diameter, AF duration, preoperative paroxysmal AF, immediate postoperative SR, and biatrial ablation for persistent AF.