The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Comparative Study Observational StudyFast-track extubation after cardiac surgery in infants: Tug-of-war between performance and reimbursement?
To compare the safety and resource-efficacy of the fast-track (FT) concept (extubation ≤8 hours after surgery) versus the conventional approach (non-FT, >8 hours postoperatively) in infants undergoing open-heart surgery. ⋯ FT concept can be performed safely and resource-effectively in infants undergoing open-heart surgery. Since German diagnosis-related group systems reimburse costs, not performance, there is little incentive to avoid prolonged mechanical ventilation. Greater ICU turnover rates and excellent postoperative outcomes are not rewarded adequately.
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Computed tomography density is not associated with pathological tumor invasion for pure ground-glass nodules.
Pure ground-glass nodules are considered to be radiologically noninvasive in lung adenocarcinoma. However, some pure ground-glass nodules are found to be invasive adenocarcinoma pathologically. This study aims to identify the computed tomography parameters distinguishing invasive adenocarcinoma from adenocarcinoma in situ and minimally invasive adenocarcinoma. ⋯ In patients with pure ground-glass nodules, computed tomography size was the only radiographic parameter associated with tumor invasion. Measuring computed tomography density provided no advantage in differentiating invasive adenocarcinoma from adenocarcinoma in situ and minimally invasive adenocarcinoma.
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Progression in Fontan conduit stenosis and hemodynamic impact during childhood and adolescence.
To characterize changes in Fontan conduit size over time and determine if cross-sectional area (CSA) affects cardiac output, pulmonary artery growth, and exercise capacity. ⋯ Fontan conduit CSA decreases as early as 6 months post-Fontan. The minimum Fontan CSA/BSA was not associated with cardiac index or pulmonary artery size but did correlate with % predicted peak oxygen consumption.
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Computed tomography-based hemodynamic index for aortic dissection.
In this study we aimed to propose a new computed tomography-based hemodynamic indicator to quantify the functional significance of aortic dissection and predict post intervention luminal remodeling. ⋯ The first balance position of luminal pressure difference quantified the hemodynamic status of the dissected aorta. The magnitude of distal shifting of the balance position after intervention was associated with functional improvement and might be used predict longitudinal aortic remodeling.