The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2022
Tricuspid leaflet kinematics after annular size reduction in ovine functional tricuspid regurgitation.
Tricuspid annular size reduction with annuloplasty rings represents the foundation of surgical repair of functional tricuspid regurgitation. However, the precise effect of annular size reduction on leaflet motion and geometry remains unknown. ⋯ Tricuspid annular area reduction of 55% perturbed anterior and posterior leaflet motion while maintaining normal septal leaflet movement. More extreme reduction triggered profound changes in anterior and posterior leaflet motion, suggesting that aggressive undersizing impairs leaflet kinematics.
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J. Thorac. Cardiovasc. Surg. · Dec 2022
ReviewA scoping review to identify competencies for transcatheter cardiovascular procedures.
Transcatheter procedures are increasingly being recognized as a priority for cardiac surgeons and cardiac surgery trainees. The optimal method of teaching these procedures during residency training has not been established. We used an evidence-based approach to systematically review the literature and identify competencies to inform future paradigms of transcatheter training in cardiac surgery. ⋯ Evidence on the competencies required to perform transcatheter cardiovascular procedures is available from a variety of sources. The identified competencies may be a useful resource for developing curricula and teaching transcatheter procedures to cardiac surgery residents.
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J. Thorac. Cardiovasc. Surg. · Dec 2022
Meta AnalysisImpact of preoperative glycometabolic status on outcomes in cardiac surgery: Systematic review and meta-analysis.
Historically, impaired glucose metabolism has been associated with early and late complicated clinical outcomes after cardiac surgery; however, such a condition is not specific to subjects with diabetes mellitus and involves a larger patient population. ⋯ Lower levels of glycosylated hemoglobin in patients undergoing cardiac surgery are associated with a lower risk of early and late mortality, as well as in the incidence of postoperative acute kidney injury, neurologic complications, and wound infection, compared with higher levels.
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J. Thorac. Cardiovasc. Surg. · Dec 2022
Editorial Meta AnalysisOpen versus hybrid versus totally minimally invasive Ivor Lewis esophagectomy: Systematic review and meta-analysis.
Hybrid and minimally invasive approaches have emerged as less invasive alternatives to open Ivor Lewis esophagectomy. The aim of this study was to compare surgical outcomes between open (OE), hybrid (HE), and totally minimally invasive esophagectomy (TMIE). ⋯ HE and TMIE are associated with lower rates of overall morbidity, reduced postoperative mortality, and shorter LOS, compared with OE. TMIE is associated with lower mortality rates and shorter LOS than HE. Further efforts are needed to widely embrace TMIE in a safe manner.
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J. Thorac. Cardiovasc. Surg. · Dec 2022
ReviewShould all patients receive extended thromboprophylaxis after resection of primary lung cancer?
The optimal duration of thromboprophylaxis in patients undergoing resection of primary lung cancer is not known. We investigated the incidence of pulmonary emboli and venous thromboembolism in patients undergoing early-stage lung cancer resection and the impact of change from short duration to extended thromboprophylaxis. ⋯ Patients undergoing lung cancer resection surgery are at moderate-to-high risk of postoperative thromboembolic disease. Extended dalteparin for 28 days is safe and is associated with reduced incidence of pulmonary embolus in patients undergoing resection of early-stage primary lung cancer.