The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Low socioeconomic status adversely affects outcomes after coronary artery bypass grafting.
Although socioeconomic status (SES) is believed to affect patient outcomes after coronary artery bypass grafting (CABG), readmission data are sparse. In a national cohort, we analyzed the influence of SES on readmission, resource utilization, and mortality after CABG. ⋯ Patients with low SES have greater adjusted odds of mortality and readmission after CABG than patients with high SES.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
25 years of Ross operation in adults: the inclusion technique keeps up the expectations.
In adults, the Ross procedure provides an excellent alternative to prosthetic valves, but it is underutilized because of concerns about technical complexity, durability, and perceived high late reoperation rates. The inclusion technique stabilizes the aortic root, prevents dilatation, and respects the dynamic root physiology. Long-term outcomes of the Ross procedure with the inclusion cylinder technique (1992-2022) are reported. ⋯ The Ross procedure with inclusion cylinder technique provides excellent hemodynamics. Autograft inclusion in the native aorta minimizes prosthetic material and respects physiological root changes, reducing shear stress on neoaortic cusps and increasing durability. Long-term reoperation rate is low in experienced centers.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Computed tomography coronary angiography as an alternative to invasive coronary angiography in preoperative evaluation for mitral surgery.
The aim of this study was to assess the effectiveness of non-invasive coronary computed tomography angiography (CTA) as an alternative to traditional invasive coronary angiography (ICA) for preoperative evaluation of low risk patients with an indication for non-emergent mitral surgery and to assess any difference in adverse outcomes from this strategy. ⋯ There were no increased odds of experiencing a major adverse event for low risk mitral valve patients undergoing preoperative coronary evaluation with CTA compared to ICA. This data has modified our practice pattern where we now offer coronary CTA to all elective patients who are low risk for coronary artery disease.