The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Early outcomes of lung transplantation with lung allografts from COVID-19-positive donors.
Coronavirus disease 2019 (COVID-19) can be detected for extended periods of time with nucleic acid amplification test even after transmissibility becomes negligible. Lung allografts from COVID-19-positive donors have been used for transplantation in highly selected cases. This study aimed to clarify the early outcomes of lung transplantation with COVID-19-positive donors. ⋯ Carefully selected lung allografts from COVID-19-positive donors had comparable early posttransplant outcomes to lung allografts from COVID-19-negative donors.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Contemporary nonsurgical management of acute type A aortic dissection: Better outcomes?
The objective of this study was to evaluate outcomes of nonsurgically managed acute type A aortic dissection (ATAAD) in the contemporary era. ⋯ Surgery remained the mainstream treatment for ATAAD. Nonsurgical management still had a role for those who were not surgical candidates because of comorbidities or malperfusion syndrome, especially in those with acute type A intramural hematoma.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
In The Era of Outpatient VADs, Is it Time to Reconsider the Practice of Bridging Older Children to Transplant on Outpatient Inotropes?
Ventricular assist devices (VADs) and inotropes are feasible modalities to bridge children to heart transplant (HT) in outpatient settings. However, it is unclear which modality yields superior clinical status at HT and posttransplant survival. ⋯ Consistent with prior studies, short-term outcomes for pediatric patients bridged to HT in the outpatient setting with VAD or inotropes is excellent. However, compared with outpatients bridged to HT on inotropes, outpatient VAD support allowed for better functional status at HT and superior late posttransplant survival.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Comparative StudyBranch First Aortic Arch Replacement Strategy Decreases Perioperative Mortality.
Sparce evidence suggests superiority of total arch replacement with the branch-first technique and antegrade cerebral perfusion over conventional techniques with respect to morbidity and mortality. Thus, we aimed to compare perioperative outcomes of patients undergoing traditional total arch replacement versus branch-first total arch replacement. ⋯ We provide evidence that branch-first total arch replacement significantly reduces 30-day mortality compared with traditional total arch replacement.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Observational StudyAssociation of Adherence to Individual Components of STS Cardiac Surgery Antibiotic Guidelines and Post-operative Infections.
The study objectives were to measure the association among the 4 components of Society of Thoracic Surgeons antibiotic guidelines and postoperative complications in a cohort of patients undergoing valve or coronary artery bypass grafting requiring cardiopulmonary bypass. ⋯ Nonadherence to Society of Thoracic Surgeons antibiotic best practices is common. Failure of antibiotic timing and weight-adjusted dosing is associated with odds of postoperative infection, sepsis, and mortality after cardiac surgery.