The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2019
Observational StudyStructural valve deterioration of biosprosthetic aortic valves: An underestimated complication.
Structural valve deterioration (SVD) remains a major bioprosthesis-related complication, as recently described for the Mitroflow valve (models LX and 12A) (LivaNova, London, United Kingdom). The real incidence of the SVD risk remains unclear, often due to methodologic pitfalls by systematically using the Kaplan-Meier estimator and/or the Cox model. In this report, we propose for the first time a precise statistical modeling of this issue. ⋯ Appropriate statistical models should be used to avoid underestimating the SVD complication associated with worse long-term survival.
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J. Thorac. Cardiovasc. Surg. · Apr 2019
Risk factors for paravalvular leak after transcatheter aortic valve replacement.
To assess risk factors for paravalvular leak (PVL) after transcatheter aortic valve implantation in a large single-center cohort, including measurement of aortic valve calcification using a reproducible method. ⋯ Aortic calcification volume in the device landing zone is associated with residual PVL after transcatheter aortic valve implantation. When taking calcification into account, the balloon-expandable prosthesis Sapien3 seems to be associated with a lower incidence of PVL.
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J. Thorac. Cardiovasc. Surg. · Apr 2019
Survival benefits associated with surgery for advanced non-small cell lung cancer.
Overall survival (OS) for advanced stage (IIIA-IV) non-small cell lung cancer (NSCLC) is highly variable, and retrospective data show a survival advantage for patients receiving therapeutic intent pulmonary resection. We hypothesized that this variability in OS can be modeled separately by stage to allow a personalized estimate of OS. ⋯ The SSS is highly predictive of individual OS and can be used as a risk assessment tool. These findings are important for a more robust evaluation of the likely benefits of surgical resection for these patients. After further prospective validation, the SSS can be used during treatment decision-making for patients with advanced-stage NSCLC.
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J. Thorac. Cardiovasc. Surg. · Apr 2019
Development of a high-fidelity minimally invasive mitral valve surgery simulator.
The aim of this study was to develop a high-fidelity minimally invasive mitral valve surgery (MIMVS) simulator. ⋯ We successfully developed a high-fidelity MIMVS simulator for endoscopic and robotic approaches. The simulator provides a platform to train skills in an objective and reproducible manner. Future studies are needed to provide evidence for its application in training surgeons.