The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Apr 2017
Comparative StudyFlipping the classroom: Case-based learning, accountability, assessment, and feedback leads to a favorable change in culture.
The 88-week Thoracic Surgery Curriculum is challenging to implement because of the large content in a traditional lecture format. This study investigates flipping the classroom by using a case-based format designed to stimulate resident preparation and engagement. ⋯ This method stimulated increased resident participation and engagement in this pilot study. Assessment scores increased at both resident levels, and resident performance exceeded faculty performance with time. By using experiential learning principles, flipping the classroom in this manner may improve educational culture by enhancing accountability, assessment, and feedback.
-
J. Thorac. Cardiovasc. Surg. · Apr 2017
Outcomes of early surgery for infective endocarditis with moderate cerebral complications.
We sought to clarify the effect of stroke severity on clinical outcomes in patients with infective endocarditis (IE) with cerebral complications and evaluate the impact of early surgery in the active phase on long-term prognosis in patients with nonsevere neurologic deficits. ⋯ Early surgery might be beneficial in patients with nonsevere stroke.
-
J. Thorac. Cardiovasc. Surg. · Apr 2017
Multicenter Study Observational StudyChanges in operative strategy for patients enrolled in the International Registry of Acute Aortic Dissection interventional cohort program.
Advancements in cardiothoracic surgery prompted investigation into changes in operative management for acute type A aortic dissections over time. ⋯ There have been significant changes in operative strategy over time in the management of type A aortic dissection, with more frequent use of valve-sparing procedures, bioprosthetic aortic valve substitutes, antegrade cerebral perfusion strategies, and hypothermic circulatory arrest. Most importantly, a significant decrease of in-hospital mortality was observed during the 20-year timespan.
-
J. Thorac. Cardiovasc. Surg. · Apr 2017
Comparative StudyPropensity-matched comparison of video-assisted thoracoscopic with thoracotomy lobectomy for locally advanced non-small cell lung cancer.
We evaluated whether video-assisted thoracoscopic lobectomy for locally advanced non-small cell lung cancer could be performed safely and with acceptable long-term outcomes by our improved technique and compared with standard thoracotomy lobectomy in a well-balanced population. ⋯ With continued experience and optimized technique, video-assisted thoracoscopic lobectomy can be performed in the majority of cases without compromising perioperative outcomes and oncologic efficacy.
-
J. Thorac. Cardiovasc. Surg. · Apr 2017
Early clinical outcomes of a novel self-expanding transapical transcatheter aortic valve bioprosthesis.
Coronary obstruction remains a challenging complication of transcatheter aortic valve replacement; however, a new self-expanding transapical prosthesis may reduce this risk. The purpose of this study was to evaluate the early 1-year outcomes of patients with low coronary heights who received the Acurate TA bioprosthesis (Symetis, Ecublens, Switzerland). ⋯ The Symetis Acurate TA device demonstrates high procedural success and excellent acute and 1-year patient outcomes. The device allows safe implantation in patients at higher risk for coronary artery obstruction.