The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2016
Randomized Controlled Trial Multicenter Study Comparative StudyFactors affecting Fontan length of stay: Results from the Single Ventricle Reconstruction trial.
In the Single Ventricle Reconstruction trial, infants with hypoplastic left heart syndrome (HLHS) who received a right-ventricle-to-pulmonary-artery shunt (RVPAS) versus a modified Blalock-Taussig shunt (MBTS) had lower early postoperative mortality, but more complications at 14 months. We explored the effect of shunt type and other patient, medical, and surgical factors on postoperative length of stay (LOS) after the Fontan operation. ⋯ In this multicenter prospective cohort of subjects with HLHS, Norwood shunt type was not associated with Fontan LOS. Rather, global measures of earlier medical complexity indicate greater likelihood of longer LOS after the Fontan operation.
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J. Thorac. Cardiovasc. Surg. · Mar 2016
Randomized Controlled TrialAmiodarone after surgical ablation for atrial fibrillation: Is it really necessary? A prospective randomized controlled trial.
Prophylactic antiarrhythmic drug (AAD) treatment is a well-established practice after catheter ablation for atrial fibrillation (AF), but it is controversial after surgical ablation. This prospective randomized controlled trial examined whether amiodarone after surgical ablation reduced atrial arrhythmia recurrence within the first 3 months after surgery. ⋯ NCT01416935.
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J. Thorac. Cardiovasc. Surg. · Mar 2016
The safety, efficacy, and durability of lung-volume reduction surgery: A 10-year experience.
The National Emphysema Treatment Trial (NETT) validated the efficacy of lung-volume reduction surgery (LVRS) in selected patients with emphysema; however, concerns about the safety and durability of the operation have limited its clinical application. We evaluated our experience with LVRS, for the time period since approval was given by the Centers for Medicare and Medicaid Services, with respect to surgical morbidity and mortality, early and late functional outcomes, and long-term survival. ⋯ Given proper patient selection, LVRS is a safe operation. Early functional measurements are consistent with significant clinical benefit. Long-term results demonstrate that improvements can be durable. Surgical LVRS continues to represent the standard for lung-volume reduction therapy.