The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Meta AnalysisPositive end-expiratory pressure and recruitment maneuvers during one-lung ventilation: A systematic review and meta-analysis.
It is unclear how positive end-expiratory pressure (PEEP) and recruitment maneuvers impact patients during one-lung ventilation (OLV). We conducted a systematic review and meta-analysis of the effect of lung recruitment and PEEP on ventilation and oxygenation during OLV. ⋯ Recruitment maneuvers and PEEP have physiologic advantages during OLV. The optimal use of PEEP is yet to be determined. The evidence is limited by heavy use of surrogate outcomes. Future studies with clinical outcomes are necessary to determine the impact of recruitment maneuvers and PEEP during OLV.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Impact of coronavirus 2019 (COVID-19) on training and well-being in subspecialty surgery: A national survey of cardiothoracic trainees in the United Kingdom.
The coronavirus 2019 (COVID-19) pandemic has overwhelmed health care systems and disrupted routine care internationally. Health care workers face disruption to their work routines and professional development, as well as an elevated risk of infection and morbidity. We sought to establish the impact of the COVID-19 pandemic on the well-being, practice, and progression of all trainees in cardiothoracic surgery in the United Kingdom. ⋯ The duration and impact of the current pandemic is, as yet, uncertain. Timely sharing of experiences, concerns, and expectations will inform health care and education policy and influence practice in the pandemic era and beyond.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Multicenter Study Comparative Study Observational StudyEarly and late outcomes following aortic root enlargement: A multicenter propensity score-matched cohort analysis.
The safety and efficacy of aortic root enlargement (ARE) at the time of aortic valve replacement (AVR) remains unknown. The objective of this multicenter study was to compare AVR with ARE to AVR for early and late mortality and secondary safety outcomes. ⋯ The addition of ARE to isolated AVR can be safely performed to increase implanted prosthesis size without compromising early mortality. Additional studies with longer follow-up are necessary.
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J. Thorac. Cardiovasc. Surg. · Oct 2020
Comparative Study Observational StudyOutcomes of different revascularization strategies among patients presenting with acute coronary syndromes without ST elevation.
To compare short- and long-term outcomes of patients hospitalized with non-ST-segment myocardial infarction (NSTEMI) or unstable angina (UA) who were referred for revascularization by either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in a real-world national cohort. ⋯ In a real-life setting, revascularization by CABG provides excellent long-term outcomes in patients with NSTEMI or UA. The advantage of CABG over PCI was seen only in male patients.