The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Results from an enhanced recovery program for cardiac surgery.
Enhanced recovery programs are multidisciplinary perioperative bundles of evidence-based process measures. Following the design and implementation of preanesthesia and intraoperative enhanced recovery programs for cardiac surgery guidelines, we evaluated the association between compliance and key clinical outcomes. ⋯ There is value in developing phase-specific enhanced recovery programs guidelines, which improve rates of early extubation and affect the duration of stay after cardiac surgery. These results are hypothesis generating, and further prospective study is necessary to identify clinical impact of further program expansion.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Influence of pregnancy on long-term durability of allografts in right ventricular outflow tract.
There is very limited published evidence about the influence of pregnancy on allograft durability in right ventricular outflow tract position. We present the first study using mixed and joint modeling. ⋯ Pregnancy is not associated with impaired allograft durability in women with good cardiac health.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Long-term outcomes after valve-sparing anatomical aortic root reconstruction in acute dissection involving the root.
To evaluate long-term results after valve-sparing surgery of acutely dissected aortic root in which a restoration of root anatomy adjusted to the existing aortic annulus diameter, rather than any kind of downsizing, was performed. ⋯ Selective replacement of pathologic sinuses offers an anatomophysiological albeit curative restoration of acutely dissected aortic root resulting in excellent and durable outcomes in selected patients with acute aortic dissection.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Concomitant left subclavian artery revascularization with carotid-subclavian transposition during zone 2 thoracic endovascular aortic repair.
Left subclavian revascularization has become an integral part of thoracic endovascular aortic repair to extend the proximal landing zone. This is most commonly achieved via carotid-subclavian bypass; however, this can be achieved via vessel transposition. ⋯ Carotid-subclavian transposition offers patients a safe and effective method for left subclavian artery revascularization during thoracic endovascular aortic repair with zone 2 coverage with no increased operative risk and a low complication rate.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Cardiothoracic surgery mock oral examinations: A single institution's 5-year experience.
Although in-training examinations provide surrogate data on qualifying exam readiness, use of mock oral examinations (MOEs) in cardiothoracic surgery training before the American Board of Thoracic Surgery certifying oral exam is not uniform. Although MOEs are prioritized by some institutions, development and execution of these labor-intensive, time-consuming exams may be a barrier to others. Therefore, we aimed to develop an MOE program and to assess its educational value. ⋯ Standardized MOEs are useful educational adjuncts to assess trainees' knowledge and readiness for certification exams, but require significant coordination and time to develop an accurate, rigorous simulation mechanism. Although we recognize that improvement in serial MOEs is likely related to exposure as well as expanding funds of knowledge, we believe these results justify use of this assessment tool in training.