The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Meta AnalysisEfficacy and effectiveness of on- versus off-pump coronary artery bypass grafting: A meta-analysis of mortality and survival.
Despite many studies comparing on- versus off-pump coronary artery bypass graft (CABG), there is no consensus as to whether one of these techniques offers patients better outcomes. ⋯ Evidence from RCTs showed no differences between the techniques, whereas rigorously adjusted observational studies (with >1.1 million patients) and the combined analysis indicated that off-pump CABG offers lower short-term mortality but poorer long-term survival. These results suggest that, in real-world settings, greater operative safety with off-pump CABG comes at the expense of lasting survival gains.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Randomized Controlled Trial Multicenter StudyFactors associated with postoperative atrial fibrillation and other adverse events after cardiac surgery.
The study objective was to evaluate the impact of various surgical characteristics and practices on the risk of postoperative atrial fibrillation and other adverse outcomes after cardiac surgery. ⋯ In this multicenter trial, we identified specific adverse outcomes that are associated with concomitant valvular and coronary artery bypass graft surgery, cardiopulmonary bypass, ventricular pacing, and occurrence of postoperative atrial fibrillation.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Survival and long-term outcomes after mitral valve replacement in patients aged 18 to 50 years.
To provide long-term data on survival and major morbidity after mitral valve replacement in patients aged 18 to 50 years. ⋯ The significant survival benefit associated with mechanical mitral valve replacement in adults ≤50 years may be due to the practice of implanting bioprostheses in sicker patients or those judged less likely to comply with long-term medication despite adjustment for baseline characteristics in propensity score matching.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Preoperative thoracic false lumen branches are predictors of aortic enlargement after stent grafting for DeBakey IIIb aortic dissection.
The study objective was to assess the effect of preoperative thoracic false lumen branches on thoracic aortic enlargement along the stent graft after thoracic endovascular aortic repair for DeBakey IIIb aortic dissection. ⋯ Preoperative thoracic false lumen branches are a morphologic predictor of thoracic aortic enlargement along the stent graft in DeBakey IIIb aortic dissection after thoracic endovascular aortic repair.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Video-assisted thoracoscopic lobectomy is associated with greater recurrence-free survival than stereotactic body radiotherapy for clinical stage I lung cancer.
Stereotactic body radiotherapy is the standard treatment for medically inoperable early-stage non-small cell lung cancer. Recent data suggest that in operable patients, stereotactic body radiotherapy produces outcomes comparable to those of surgical resection. In veterans with early non-small cell lung cancer, we compared the outcomes of stereotactic body radiotherapy and video-assisted thoracoscopic lobectomy. ⋯ In veteran patients with early-stage non-small cell lung cancer, video-assisted thoracoscopic lobectomy resulted in better disease control and survival than stereotactic body radiotherapy. Although prior reports suggest that stereotactic body radiotherapy is a suitable alternative to surgery in early-stage lung cancer, a prospective randomized trial is needed. Nevertheless, stereotactic body radiotherapy remains a suitable option for medically inoperable patients.