The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Temporary ventricular assist device support with a catheter-based axial pump: Changing the paradigm at a pediatric heart center.
We report the largest pediatric single-center experience with an Impella (Abiomed Inc) catheter-based axial pump support. ⋯ We demonstrate that catheter-based axial pump support in children results in excellent 1- and 6-month survival with an acceptable adverse event profile.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Multicenter StudyAtrial fibrillation ablation improves late survival after concomitant cardiac surgery.
Preoperative atrial fibrillation (AF) increases risk of stroke, heart failure, and all-cause mortality after cardiac surgery. Despite encouraging results and guideline recommendations, surgical ablation (SA) for AF concomitant with other heart surgery remains low. In the current study we aimed to address the long-term mortality after SA concomitant with cardiac surgery. ⋯ In this multicenter, retrospective, propensity matched study, SA concomitant with other cardiac surgery was associated with improved long-term survival regardless of baseline surgical risk.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Aortic Area/Height Ratio, Peak Wall Stresses, and Outcomes in Veterans with Tricuspid vs Bicuspid Aortic Valve Associated Ascending Thoracic Aortic Aneurysms.
In ascending thoracic aortic aneurysm risk stratification, aortic area/height ratio is a reasonable alternative to maximum diameter. Biomechanically, aortic dissection may be initiated by wall stress exceeding wall strength. Our objective was to evaluate the association between aortic area/height and peak aneurysm wall stresses in relation to valve morphology and 3-year all-cause mortality. ⋯ Area/height was more predictive of high circumferential stresses in bicuspid than tricuspid valve aneurysms, but similarly less predictive of high longitudinal stresses in both valve types. Peak longitudinal stress, not area/height, independently predicted all-cause mortality. VIDEO ABSTRACT.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Clinical utility of a deep-learning mortality prediction model for cardiac surgery decision making.
The aim of this study using decision curve analysis (DCA) was to evaluate the clinical utility of a deep-learning mortality prediction model for cardiac surgery decision making compared with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II and to 2 machine-learning models. ⋯ The deep-learning model had better predictive accuracy and greater clinical utility than the EuroSCORE II and the 2 machine-learning models. These findings suggest that deep learning with Tabular Bidirectional Encoder Representations from Transformers prediction model could be used in the future as the gold standard for cardiac surgery decision making.