The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
Early prediction of clinical deterioration using data-driven machine-learning modeling of electronic health records.
To develop and evaluate a high-dimensional, data-driven model to identify patients at high risk of clinical deterioration from routinely collected electronic health record (EHR) data. ⋯ I-WIN accurately predicted deterioration events in critically-ill infants with high-risk congenital heart disease up to 8 hours before deterioration, potentially allowing clinicians to target interventions. We propose a paradigm shift from conventional expert consensus-based selection of risk factors to a data-driven, machine-learning methodology for risk prediction. With the increased availability of data capture in EHRs, I-WIN can be extended to broader applications in data-rich environments in critical care.
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
Multicenter StudyThe role of virtual-assisted lung mapping 2.0 combining microcoils and dye marks in deep lung resection.
Virtual-assisted lung mapping 2.0 is a novel preoperative bronchoscopic lung mapping technique combining the multiple dye marks of conventional virtual-assisted lung mapping with intrabronchial microcoils to navigate thoracoscopic deep lung resection. This study's purpose was to evaluate the feasibility of virtual-assisted lung mapping 2.0 in resecting deeply located pulmonary nodules with adequate margins. ⋯ This study demonstrated that virtual-assisted lung mapping 2.0 can facilitate successful resections for deep pulmonary nodules, overcoming the limitations of conventional virtual-assisted lung mapping.
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
Neighborhood socioeconomic status is associated with differences in operative management and long-term survival after coronary artery bypass grafting.
We sought to characterize differences in operative management and surgical outcomes after coronary artery bypass grafting associated with the socioeconomic context in which a patient lives. ⋯ The socioeconomic context in which a patient lives is significantly associated with short- and long-term outcomes after coronary artery bypass grafting. There may also be variation in operative management, demonstrated by decreased use of arterial conduits. Lower rates of arterial revascularization among socioeconomically disadvantaged patients who undergo coronary artery revascularization may provide a target for intervention.
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
The differences in surgical long-term outcomes between Marfan syndrome and Loeys-Dietz syndrome.
The aim of this study was to disclose the differences of surgical outcomes between Marfan syndrome with mutations in fibrillin-1 gene and Loeys-Dietz syndrome with mutations in transforming growth factor-beta receptor 1 and 2. ⋯ Loeys-Dietz syndrome with mutations in transforming growth factor-beta receptor 1 and 2 revealed higher rates of reoperation, and more specifically the arch reoperation was higher in those with Loeys-Dietz syndrome than those with Marfan syndrome. Aggressive arch surgery in the initial operation on the proximal aorta is recommendable in Loeys-Dietz syndrome to avoid additional aortic events. In Marfan syndrome, this is controversial in patients without dissection because of a low possibility to expand.