The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Event-Free Survival as a Predictor of Overall Survival and Recurrence Burden of Patients with Non-Small Cell Lung Cancer Receiving Neoadjuvant Therapy.
Event-free survival has replaced overall survival as a primary end point in many recent and ongoing clinical trials. This study aims to examine the correlation between real-world event-free survival and overall survival and to assess the clinical and economic burden associated with disease recurrence among patients with resected stage II to III non-small cell lung cancer who received neoadjuvant therapy in the United States. ⋯ These findings help validate event-free survival as a clinically meaningful end point and strong predictor for overall survival and highlight the need for additional novel therapies that may delay or prevent recurrence in resectable stage II and III non-small cell lung cancer.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Prognostic Utility of a Risk Prediction Model for Pre-Discharge Major Residual Lesions or Unplanned Reinterventions Following Congenital Mitral Valve Repair.
We sought to develop a risk prediction model for predischarge major mitral valve (MV) residual lesions or unplanned MV reinterventions following congenital MV repair. ⋯ Our risk prediction model may guide prognostication of patients following congenital MV repair.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Renal recovery in cardiac surgery patients requiring postoperative renal replacement therapy.
Renal failure after cardiac surgery is associated with increased morbidity and mortality. There is a lack of data examining the rate of renal recovery after patients have started dialysis following cardiac surgery. We aimed to determine the frequency of and time to renal recovery of patients requiring dialysis after cardiac surgery. ⋯ More than two-thirds of patients with renal failure who survived the perioperative period had renal recovery within 1 year after surgery. Recovery was driven primarily by postoperative complications rather than comorbidities and intraoperative factors, suggesting renal failure in the postoperative cardiac surgery patient surviving to discharge is unlikely to be permanent.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Transapical Ventricular Reshaping Reduces Functional Mitral Regurgitation and Improves Ventricular Function in a Preclinical Model of Ischemic Cardiomyopathy.
A significant proportion of patients with advanced heart failure present with dilated left ventricles and functional mitral regurgitation. These patients currently have limited treatment options. The MitraClip device (Abbott) has benefited only patients with smaller left ventricles (end-diastolic dimension <70 mm), whereas those with larger left ventricles did not benefit. A possible explanation is correcting functional mitral regurgitation alone may not adequately reduce the wall stresses of a dilated left ventricle. We have developed a beating-heart device that not only approximates the papillary muscles to reduce functional mitral regurgitation but also modifies the left ventricle size and shape to reduce wall stress. ⋯ Correction of functional mitral regurgitation with favorable changes in mitral valve geometry and reduction in left ventricle geometry is possible with the proposed device.