The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Preoperative predictors of new-onset prolonged atrial fibrillation after surgical aortic valve replacement.
Patients undergoing surgical aortic valve replacement (SAVR) are at risk of developing prolonged atrial fibrillation (AF) after surgery. Prophylactic interventions such as left atrial appendage amputation (LAAA) and pulmonary vein isolation (PVI) impose cost and operative risk, discouraging routine use. To guide such interventions, we investigated preoperative predictors of AF. ⋯ Older age and left atrial enlargement identify a stratum of patients at high risk of developing prolonged postoperative AF after SAVR. Multicenter, prospective studies should investigate the value of prophylactic interventions such as LAAA, Cox maze, or PVI in these individuals to obviate the consideration of late anticoagulation.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Left ventricular assist device implantation may be feasible in appropriately selected patients with severe renal insufficiency.
Severe renal insufficiency is considered a relative contraindication to left ventricular assist device (LVAD) implantation. After establishing an algorithmic approach to these patients, we hypothesized that LVAD implantation with severe renal insufficiency could be performed without increasing morbidity or mortality. ⋯ LVAD implantation in carefully selected patients with severe renal insufficiency can be performed without increasing midterm morbidity or mortality. This strategy may serve as a successful option to bridge patients to transplantation or destination therapy.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
The influence of hormone replacement therapy on lung cancer incidence and mortality.
Data regarding the effects of hormone replacement therapy (HRT) on non-small cell lung cancer (NSCLC) are mixed. We hypothesized HRT would have a protective benefit with reduced NSCLC incidence among women in a large, prospective cohort. ⋯ These data represent among the largest prospective cohorts suggesting HRT use may have a protective effect on the development of NSCLC among women; the physiological basis of this effect merits further study; however, the results may influence discussion surrounding HRT use in women.