The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Meta AnalysisPeripheral versus central extracorporeal membrane oxygenation for postcardiotomy shock: Multicenter registry, systematic review, and meta-analysis.
We hypothesized that cannulation strategy in venoarterial extracorporeal membrane oxygenation (VA-ECMO) could play a crucial role in the perioperative survival of patients affected by postcardiotomy shock. ⋯ In patients with postcardiotomy shock treated with VA-ECMO, central cannulation was associated with greater in-hospital mortality than peripheral cannulation.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Multicenter StudyImproved survival after lung transplantation for adults requiring preoperative invasive mechanical ventilation: A national cohort study.
Early survival after lung transplantation has improved in the last decade. Mechanically ventilated recipients are known to be at greater risk for early post-transplant mortality. We hypothesized that post-transplant survival in mechanically ventilated recipients has improved over time. ⋯ While mechanically ventilated recipients remain at high risk, survival in this patient population has improved over time. This may reflect improvements in perioperative recipient management.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Non-vitamin K oral anticoagulant use after cardiac surgery is rapidly increasing.
The prevalence of non-vitamin K oral anticoagulant use after cardiac surgery is unknown, particularly in patients with bioprosthetic valves. We sought to define the contemporary use and short-term safety of non-vitamin K oral anticoagulants after cardiac surgery. ⋯ Non-vitamin K oral anticoagulant use after cardiac surgery has dramatically increased since 2011. This trend is consistent regardless of indication for anticoagulation including bioprosthetic valves. Short-term outcomes support their safety in the cardiac surgery setting with shorter postoperative hospital stays. Long-term studies on the efficacy of non-vitamin K oral anticoagulants after cardiac surgery are still necessary.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non-small cell lung cancer.
Concern exists regarding surgery after thoracic radiation. We aimed to assess early results of anatomic resection following induction therapy with platinum-based chemotherapy and full-dose thoracic radiation for resectable N2+ stage IIIA non-small cell lung cancer. ⋯ Lobectomy was performed safely following full-dose concurrent chemoradiotherapy in these multi-institutional prospective trials; however, increased mortality was noted with extended resections.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Second crossclamp to perfect degenerative mitral valve repair: Decision-making algorithm, safety, and outcomes.
Residual mitral regurgitation reduces the efficacy of mitral repair and is associated with worse outcomes. We adopted a policy using a second bypass run for patients with residual mitral regurgitation (>+1) and described our decision-making algorithm and outcomes. ⋯ Residual mitral regurgitation can be effectively treated using a second bypass run with good long-term outcome and minimal incremental risk.