The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Valve Sparing Aortic Root Replacement in the Resternotomy Setting.
Although valve-sparing aortic root replacement (VSRR) has demonstrated satisfactory outcomes, its utility in reoperative sternotomy settings remains uncertain. This study evaluates the perioperative safety and long-term durability of reoperative sternotomy VSRR. ⋯ Although complex, reoperative sternotomy VSRR can be performed with low operative mortality in carefully selected patients. Ten-year survival and aortic valve reintervention rates were acceptable and comparable to primary VSRR.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Interhospital Variability in 180-day Infections Following Cardiac Surgery.
To evaluate hospital-level variation in infections following cardiac surgery and develop and evaluate a 180-day infection quality metric. ⋯ One in 5 Medicare beneficiaries develop a 180-day infection following cardiac surgery, with rates varying 39.5% across hospitals. Patients at higher versus lower O:E tercile hospitals were more commonly discharged to extended care/rehabilitation settings, although rates of stroke and mortality were equivalent in the 2 groups. Collaborative learning interventions may be warranted to advance the observed variability in 180-day infections.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Occluded Fenestration is Associated with Improved Long-Term Outcomes in Patients Undergoing the Fenestrated Fontan Operation.
The modified Fontan operation, a palliative approach for patients with single ventricular circulation, often incorporates a fenestration to facilitate postoperative management. Postoperative fenestration closure sometimes is performed to mitigate potential risks such as low oxygen saturation. However, the benefits and potential risks of this procedure remain under investigation. ⋯ Patients with occluded fenestration exhibited superior event-free survival. Fenestration closure is a feasible strategy to enhance oxygen saturation without elevating Fontan pressure.