The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Multicenter StudyRisk of reoperative valve surgery for endocarditis associated with drug use.
We aimed to quantify incidence and operative risks associated with reoperative valve surgeries (RVS) in patients with drug-associated infective endocarditis in a multi-center setting. ⋯ An increasing proportion of valve surgery for drug-associated infective endocarditis is for RVS. Despite being young and harboring few comorbidities, the RVS cohort is still susceptible to increased risk of 30-day mortality compared with those undergoing FVS.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Multicenter StudyIntraoperative transit-time flow measurement and high-frequency ultrasound assessment in coronary artery bypass grafting.
We evaluated the influence of transit-time flow measurement with epicardial and epiaortic high-frequency ultrasound in patients undergoing coronary artery bypass grafting procedure. ⋯ Surgical changes related to the aorta, conduits, coronary targets, and anastomosis were made in 25% of patients. This was associated with low operative mortality and low major morbidity. Transit-time flow measurement and high-frequency ultrasound may improve the quality, safety, and efficacy of coronary artery bypass grafting procedures and should be considered as a routine procedural aspect.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis.
We hypothesized that an increased duration of donor brain death may worsen survival following orthotopic heart transplantation. ⋯ Longer duration of brain death was not associated with worse survival following heart transplantation. Donors with prolonged interval of brain death should not necessarily be excluded based on brain death period alone.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Influence of a high-intensity staffing model in a cardiac surgery intensive care unit on postoperative clinical outcomes.
Various staffing models have been applied in intensive care units (ICUs) to improve outcomes. However, there is a lack of evidence regarding the effect of staffing models in cardiac surgery ICUs. Thus, we aimed to evaluate the efficacy of high-intensity staffing in cardiac surgery ICUs. ⋯ High-intensity staffing model during daytime hours by cardiac surgery intensivists significantly improved ICU-related outcomes. However, high-intensity staffing did not affect early mortality after cardiac surgery.
-
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.