The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Expanded polytetrafluoroethylene conduits with curved and hand-sewn bileaflet designs for right ventricular outflow tract reconstruction.
This study reviewed the application of curved and bileaflet designs to pulmonary expanded polytetrafluoroethylene conduits with diameters of 10 to 16 mm and characterized this conduit on in vitro experiment, including particle image velocimetry. ⋯ Our conduits with curved and bileaflet designs have acceptable clinical durability and proven hydrodynamic profiles, which eliminate valve regurgitation and serve as a reliable bridge to subsequent conduit replacement.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Surgical ablation for atrial fibrillation is efficacious in patients with giant left atria.
The Cox-Maze IV procedure (CMP-IV) is the most effective treatment for atrial fibrillation. Increased left atrial (LA) size has been identified as a risk factor for failure to restore sinus rhythm. This has biased many surgeons against ablation in patients with giant left atrium (GLA), defined as LA diameter >6.5 cm. In this study we aimed to define the efficacy of the CMP-IV in patients with GLA. ⋯ The CMP-IV had good efficacy in patients with GLA. Our results suggest that LA diameter >6.5 cm should not preclude a patient from undergoing surgical ablation for atrial fibrillation.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Characteristics and prognostic significance of right heart remodeling and tricuspid regurgitation after pulmonary endarterectomy.
Right heart remodeling and tricuspid regurgitation (TR) are common in patients with chronic thromboembolic pulmonary hypertension. This study aimed to investigate the significance of right heart remodeling and TR after pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension. ⋯ Significant improvements in right heart remodeling were seen following PEA. However, residual TR was a poor prognostic marker.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Workforce Diversity in Cardiothoracic Surgery: An Examination of Recent Demographic Changes and the Training Pathway.
The purpose of our study was to examine changes in the demographic makeup of resident physicians in integrated 6-year cardiothoracic surgery and traditional thoracic surgery residency programs from 2013 to 2022 compared with other surgical subspecialties and determine potential leaks in the training pathway. ⋯ Cardiothoracic surgery has not significantly increased the number of Black and Hispanic trainees during the past decade. The lower proportion of Blacks and women in thoracic surgery residency and fellowship programs compared with their proportion in medical schools is concerning and is an opportunity for intervention.
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J. Thorac. Cardiovasc. Surg. · Feb 2024
Development of a risk score to predict occurrence of deep sternal dehiscence requiring operative debridement.
Severe deep sternal wound (DSW) complications after cardiac surgery are a source of cost, morbidity, and mortality. Our objective was to develop and validate a clinical risk score for predicting risk of DSW requiring operative bone debridement, the most severe form of sternal dehiscence. ⋯ This risk stratification model for DSW requiring operative debridement might provide individualized estimates of risk, and guide counseling and potential risk mitigation strategies.