The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Influence of experience and the surgical learning curve on long-term patient outcomes in cardiac surgery.
We hypothesized that increased postgraduate surgical experience correlates with improved operative efficiency and long-term survival in standard cardiac surgery procedures. ⋯ In cardiac surgery, not including CABG, surgeon experience is an important determinant of operative efficiency and of long-term survival.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
EditorialIs the air in Toronto, Rochester, and Cleveland different from that in London, Monaco, Leiden, Genk, Milan, and New York?
The tricuspid valve has been recently referred to as the "forgotten valve," because one now realizes that tricuspid regurgitation is bad for the patient and that reoperation for progressive tricuspid regurgitation after a left-sided valvular correction still carries a high mortality risk. However, the indication for concomitant tricuspid valve repair during a mitral valve repair procedure is still controversial, as illustrated by the reaction of Dr T. David to the presentation of Dr Chikwe and colleagues at the 2015 American Association for Thoracic Surgery meeting. ⋯ An annular dilation of 40 mm or 21 mm/m(2) has been proposed and validated by many authors. The preoperative functional class also plays a major role. Tricuspid regurgitation is a progressive disease, but the presence of a concomitant mitral valve disease may aggravate annular dilation; therefore, the earlier we operate on the mitral valve, the less frequently patients will require concomitant tricuspid valve repair.