The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2016
Randomized Controlled Trial Multicenter StudyPedicled and skeletonized single and bilateral internal thoracic artery grafts and the incidence of sternal wound complications: Insights from the Arterial Revascularization Trial.
The question of whether skeletonized internal thoracic artery harvesting reduces the incidence of sternal wound complications in comparison with the pedicled technique, in the context of single or bilateral internal thoracic arteries, remains controversial. We studied the impact of the internal thoracic artery harvesting strategy on sternal wound complication in the Arterial Revascularization Trial. ⋯ The present Arterial Revascularization Trial substudy suggests that, with a skeletonization technique, the risk of sternal wound complication with bilateral internal thoracic artery grafting is similar to that after standard pedicled single internal thoracic artery harvesting, whereas skeletonized single internal thoracic artery harvesting did not add any further benefit when compared with pedicled single internal thoracic artery harvesting.
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J. Thorac. Cardiovasc. Surg. · Jul 2016
The predictive value of s-cystatin C for mortality after coronary artery bypass surgery.
To evaluate serum creatinine (s-creatinine) and serum cystatin C (s-cystatin C) levels and estimated glomerular filtration rate (eGFR) at different time points as predictors for mortality in patients undergoing coronary artery bypass grafting (CABG). ⋯ The s-cystatin C level and s-cystatin C-based eGFR measured preoperatively are strong predictors for mortality after elective CABG.
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J. Thorac. Cardiovasc. Surg. · Jul 2016
Multicenter StudyThe effect of coronary angiography timing and use of cardiopulmonary bypass on acute kidney injury after coronary artery bypass graft surgery.
Acute kidney injury is a common but serious complication of coronary artery bypass grafting. We investigated whether the effect of the timing of coronary angiography on acute kidney injury after coronary artery bypass grafting is influenced by the use of cardiopulmonary bypass. ⋯ A shorter interval between coronary angiography and surgery influenced the occurrence of acute kidney injury in patients undergoing on-pump coronary artery bypass. However, the interval is not an independent risk factor for the development of postoperative acute kidney injury in patients who undergo off-pump coronary artery bypass.
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J. Thorac. Cardiovasc. Surg. · Jul 2016
Cardiac magnetic resonance imaging characterizes stenosis, perfusion, and fibrosis preoperatively and postoperatively in children with anomalous coronary arteries.
Using cardiac magnetic resonance imaging (MRI) with virtual angioscopy, we sought to evaluate coronary anatomy, myocardial injury, and left ventricular function in children with interarterial anomalous aortic origin of coronary artery before and after surgery. ⋯ Cardiac MRI with virtual angioscopy is an important tool for evaluating anomalous coronary anatomy, myocardial function, and ischemia and should be considered for initial and postoperative assessment of children with anomalous coronary arteries.
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J. Thorac. Cardiovasc. Surg. · Jul 2016
EditorialOnline network of subspecialty aortic disease experts: Impact of "cloud" technology on management of acute aortic emergencies.
For the management of acute aortic syndromes, regional treatment networks have been established to coordinate diagnosis and treatment between local emergency rooms and central specialized centers. Triage of acute aortic syndromes requires definitive imaging, resulting in complex data files. Modern information technology network structures, specifically "cloud" technology, coupled with mobile communication, increasingly support sharing of these data in a network of experts using mobile, online access and communication. Although this network is technically complex, the potential benefit of online sharing of data files between professionals at multiple locations within a treatment network appear obvious; however, clinical experience is limited, and further evaluation is needed.