The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2019
Comparative StudyImpact of "increased-risk" donor hearts on transplant outcomes: A propensity-matched analysis.
Orthotopic heart transplantation (OHT) remains the gold standard for advanced heart failure. Increased risk (IR) donors were categorized by the United Network for Organ Sharing Database (UNOS) according to the Centers for Disease Control and Prevention (CDC) criteria. However, the impact of CDC IR donor hearts on the outcome of adult OHT recipients remains unclear. The aim of this study was to compare the outcome of adult OHT recipients between CDC IR and non-CDC IR donor grafts. ⋯ CDC IR status does not have a significant impact on adult OHT recipient survival probability. Increased use of CDC IR donor grafts can potentially alleviate the persistent and worsening shortage of available donor organs and shorten the waitlist time for heart transplantation.
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J. Thorac. Cardiovasc. Surg. · Feb 2019
Poorer sleep quality among adult patients with pectus excavatum in Taiwan: A pilot study.
Patients with pectus excavatum have a poorer quality of life than the general population. Sleep quality is a critical component of quality of life. This pilot study compared the sleep quality of adult patients with pectus excavatum with that of the general population in Taiwan. ⋯ Our findings suggested an association between poor sleep quality and pectus excavatum; thus, sleep quality should be evaluated before and after the Nuss procedure.
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J. Thorac. Cardiovasc. Surg. · Feb 2019
Ivor Lewis minimally invasive esophagectomy for esophageal cancer: An excellent operation that improves with experience.
Esophagectomy is associated with major morbidity. In this study we sought to assess the learning curve of minimally invasive Ivor Lewis esophagectomy (MIILE) and to evaluate perioperative outcomes, including anastomotic leak and hospital readmission, as a function of graduated surgeon experience. ⋯ MIILE can be performed safely and effectively with improving results as the surgeon's experience evolves.
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J. Thorac. Cardiovasc. Surg. · Feb 2019
First series of minimally invasive, robot-assisted tracheobronchoplasty with mesh for severe tracheobronchomalacia.
Tracheobronchomalacia is a progressive, debilitating disease with limited treatment options. Open tracheobronchoplasty (TBP) is an accepted surgical option for management of severe tracheobronchomalacia. This study examined the outcomes of the first reported series of robot-assisted TBP (R-TBP). ⋯ R-TBP can be performed with low morbidity and mortality. Early follow-up reveals significant improvement in pulmonary function testing and high patient satisfaction when compared with preoperative baseline. Long-term follow-up is needed to demonstrate the durability of R-TBP and substantiate its role in the management of patients with symptomatic, severe tracheobronchomalacia.
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J. Thorac. Cardiovasc. Surg. · Feb 2019
Increased mortality, morbidities, and costs after heart transplantation in heterotaxy syndrome and other complex situs arrangements.
Identify pediatric heart transplant (HT) recipients with heterotaxy and other complex arrangements of cardiac situs (heterotaxy/situs anomaly) and compare mortality, morbidities, length of stay (LOS), and costs to recipients with congenital heart disease without heterotaxy/situs anomaly. ⋯ Heterotaxy and other complex arrangements of cardiac situs are associated with increased mortality, postoperative complications, LOS, and costs after HT. Although increased surgical complexity can account for many of these differences, inferior late survival is not well explained and deserves further study.