The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2020
Randomized Controlled TrialOptimizing cerebral oxygenation in cardiac surgery: A randomized controlled trial examining neurocognitive and perioperative outcomes.
The study objective was to determine whether targeted therapy to optimize cerebral oxygenation is associated with improved neurocognitive and perioperative outcomes. ⋯ Targeted therapy to optimize cerebral oxygenation was associated with better memory outcome in a group of cardiac surgical patients. Some aspects of the protocol other than desaturation duration and severity contributed to the observed neuroprotective effect.
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J. Thorac. Cardiovasc. Surg. · Mar 2020
Comparative StudyResection Process Map: A novel dynamic simulation system for pulmonary resection.
Use of 3-dimensional computed tomography for preoperative and intraoperative simulation has been introduced in the field of thoracic surgery. However, 3-dimensional computed tomography provides only static simulation, which is a significant limitation of surgical simulation. Dynamic simulation, reflecting the intraoperative deformation of the lung, has not been developed. The aim of this study was to develop a novel simulation system that generates dynamic images based on patient-specific computed tomography data. ⋯ We successfully developed a novel dynamic simulation system, the Resection Process Map, for anatomic pulmonary resection.
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J. Thorac. Cardiovasc. Surg. · Mar 2020
Global cardiac surgery: Access to cardiac surgical care around the world.
Cardiovascular disease is the leading cause of death worldwide, responsible for 17.5 million deaths every year, of which 80% occur in low- and middle-income countries. Some 75% of the world does not have access to cardiac surgery when needed because of lack of infrastructure, human resources, and financial coverage. This study aims to map access to cardiac surgery around the world. ⋯ This study maps the current global state of access to cardiac surgery. Disparities exist between and within world regions, with a positive correlation between a nation's economic status and access to cardiac surgery. Low early mortality rates in low-resource settings suggest the possibility of high-quality cardiac surgery in low- and middle-income countries. There is the need to increase human and physical resources, while focusing on safety, quality, and efficiency to improve access to cardiac surgery for the 4.5 billion people without.