The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2015
Ventricular kinetic energy may provide a novel noninvasive way to assess ventricular performance in patients with repaired tetralogy of Fallot.
Ventricular kinetic energy measurements may provide a novel imaging biomarker of declining ventricular efficiency in patients with repaired tetralogy of Fallot. Our purpose was to assess differences in ventricular kinetic energy with 4-dimensional flow magnetic resonance imaging between patients with repaired tetralogy of Fallot and healthy volunteers. ⋯ Greater ventricular kinetic energy is necessary to generate flow in the pulmonary and aortic circulations in repaired tetralogy of Fallot. Quantification of ventricular kinetic energy in patients with repaired tetralogy of Fallot is a new observation. Future studies are needed to determine whether changes in ventricular kinetic energy can provide earlier evidence of ventricular dysfunction and guide future medical and surgical interventions.
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J. Thorac. Cardiovasc. Surg. · May 2015
Multicenter StudyFailure to rescue and pulmonary resection for lung cancer.
Failure to rescue is defined as death after an acute inpatient event and has been observed among hospitals that perform general, vascular, and cardiac surgery. This study aims to evaluate variation in complication and failure to rescue rates among hospitals that perform pulmonary resection for lung cancer. ⋯ Variation in hospital mortality seems to be more strongly related to rescuing patients from complications than to the occurrence of complications. This observation is significant because it redirects quality improvement and health policy initiatives to more closely examine and support system-level changes in care delivery that facilitate early detection and treatment of complications.
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J. Thorac. Cardiovasc. Surg. · May 2015
Observational StudyElevated endothelin-1 level is a risk factor for nonocclusive mesenteric ischemia.
Nonocclusive mesenteric ischemia may occur after cardiac surgery, commonly in conjunction with the use of cardiopulmonary bypass. Some evidence suggests that endothelin-1 serum levels are increased in patients with mesenteric ischemia, but the association of endothelin-1 and nonocclusive mesenteric ischemia has not been studied. The objective was to investigate whether elevated levels of endothelin-1 could be found in patients exhibiting nonocclusive mesenteric ischemia. ⋯ Endothelin-1 seems to predispose patients undergoing cardiac surgery to develop nonocclusive mesenteric ischemia. In addition, it may be a useful marker to identify patients at risk for nonocclusive mesenteric ischemia after cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · May 2015
Incidence and risk factors of postpericardiotomy syndrome requiring medical attention: The Finland postpericardiotomy syndrome study.
Postpericardiotomy syndrome is a well-known complication after cardiac surgery. Nevertheless, little is known about the incidence and predictors of postpericardiotomy syndrome requiring medical attention or hospitalization in a contemporary set of patients undergoing isolated coronary bypass. ⋯ The incidence of symptomatic postpericardiotomy syndrome leading to medical care contact was markedly lower compared with that reported in older clinical studies. Postpericardiotomy syndrome was associated with the use of red blood cell units and was less common in patients with medically treated diabetes.
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J. Thorac. Cardiovasc. Surg. · May 2015
Why are patients being readmitted after surgery for esophageal cancer?
Readmission after surgery is an unwanted adverse event that is costly to the healthcare system. We sought to evaluate factors associated with increased risk of readmission and to characterize the nature of these readmissions in patients who have esophageal cancer. ⋯ Complications not adequately managed before discharge may lead to readmission. Quality improvement efforts surrounding venous thromboembolism prophylaxis, and discharging patients nothing-by-mouth, may be warranted.