The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Multicenter Study Comparative StudyCurrent practice patterns for use of the radial artery for coronary surgery in dedicated centers.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Cardiac surgery outcomes in patients with coronavirus disease 2019 (COVID-19): A case-series report.
The impact of coronavirus disease 2019 (COVID-19) on the postoperative course of patients after cardiac surgery is unknown. We experienced a major severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in our cardiac surgery unit, with several patients who tested positive early after surgery. Here we describe the characteristics, postoperative course, and laboratory findings of these patients, along with the fate of the health care workers. We also discuss how we reorganize and reallocate hospital resources to resume the surgical activity without further positive patients. ⋯ COVID-19 infection after cardiac surgery, regardless the time of the onset, is a serious condition. The systemic inflammatory state that follows extracorporeal circulation may mask the typical COVID-19 laboratory findings, making the diagnosis more difficult. A strict reorganization of the hospital resources is necessary to safely resume the cardiac surgical activity.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Effect of thoracic surgery regionalization on long-term survival after lung cancer resection.
Existing evidence demonstrates some benefit of regionalization on early postoperative outcomes following lung cancer resection, but data regarding the persistence of this effect in long-term mortality are lacking. We investigated whether previously reported improvements in short-term outcomes translated to long-term survival benefit. ⋯ We found that overall mortality as well as 1- and 3-year mortality for lung cancer resection were lower after thoracic surgery regionalization. The association between regionalization and reduced mortality was significant even after adjusting for other related factors in a multivariable Cox analysis. Notably, surgeon volume, facility volume, surgeon specialty, neoadjuvant treatment, and video-assisted thoracoscopic surgery approach did not significantly affect mortality in the adjusted model.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Comparative Study Observational StudyMidterm outcomes and durability of sinus segment preservation compared with root replacement for acute type A aortic dissection.
The durability of root repair for acute type A aortic dissection is not well studied in the context of aortic insufficiency and stability of the sinuses of Valsalva. We compared clinical and functional outcomes in patients undergoing root repair and replacement for acute type A aortic dissection. ⋯ Survival is similar, but the incidence of aortic insufficiency and root dilation may be greater after root repair compared with root replacement for acute type A aortic dissection.