The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2016
Comparative StudySurgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection.
Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. ⋯ Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection.
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J. Thorac. Cardiovasc. Surg. · May 2016
Comparative StudyA novel score to estimate the risk of pneumonia after cardiac surgery.
The purpose of this study was to derive and validate a risk score for pneumonia (PNA) after cardiac surgery. ⋯ This 33-point risk score is strongly predictive of postoperative PNA after cardiac surgery. The composite score has utility in tailoring perioperative management and in targeting diagnostic and preventative interventions.
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J. Thorac. Cardiovasc. Surg. · May 2016
Comparative StudyLong-term outcome of revascularization with composite T-grafts: Is bilateral mammary grafting better than single mammary and radial artery grafting?
Bilateral internal mammary artery (BIMA) grafting is associated with improved survival. However, many surgeons are reluctant to use this technique, owing to the potentially increased risk of sternal infection. The composite T-graft with radial artery (RA) attached end-to-side to the left internal mammary artery (IMA) provides complete arterial revascularization without increased risk of sternal infection. The purpose of this study is to compare outcomes of these 2 strategies. ⋯ This study suggests that long-term outcomes of arterial revascularization with a composite T-graft constructed using left IMA and RA are not inferior to outcomes after BIMA grafting.
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J. Thorac. Cardiovasc. Surg. · May 2016
Comparative StudyLong-term results after surgical treatment of paravalvular leak in the aortic and mitral position.
The aim of this study was to determine immediate results and long-term outcomes after surgical management of paravalvular leak (PVL). ⋯ Surgical treatment of PVL resulted in acceptable outcomes. Nevertheless, the continued risk of PVL recurrence is higher in patients who have had multiple previous surgeries. More studies are needed to compare these results with the transcatheter PVL reduction technique.
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J. Thorac. Cardiovasc. Surg. · May 2016
Comparative StudyCardiac magnetic resonance radiofrequency tissue tagging for diagnosis of constrictive pericarditis: A proof of concept study.
Invasive cardiac catheterization is the venerable "gold standard" for diagnosing constrictive pericarditis. However, its sensitivity and specificity vary dramatically from center to center. Given the ability to unequivocally define segments of the pericardium with the heart via radiofrequency tissue tagging, we hypothesize that cardiac magnetic resonance has the capability to be the new gold standard. ⋯ Cardiac magnetic resonance via radiofrequency tissue tagging offers a unique, efficient, and effective manner of defining clinically and surgically relevant constrictive pericarditis. Specifically, no patient who was identified with constriction via cardiac magnetic resonance underwent inappropriate sternotomy. However, catheterization had substantial and unacceptable false-positive and false-negative rates with important clinical ramifications.