The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Postoperative Outcomes Following Lung Resection Performed at Private Equity-Acquired Hospitals.
Private equity acquisition of hospitals performing complex operations is increasingly prevalent in the United States healthcare landscape. While comparative health outcomes for common medical conditions have been investigated, the quality of thoracic surgical care in private equity-acquired hospitals is unknown. ⋯ These findings raise concern that private equity-acquired hospitals may provide lower-quality care for patients undergoing common thoracic procedures. Underlying structural factors may contribute to these differences. This motivates further investigation of specialty surgical care performed at private equity-acquired health institutions.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
From Zone -1 to Zone 3: Feasibility and Safety of Complex Endovascular Aortic Repairs in Type A Aortic Dissection.
Over 30% of patients presenting with acute type A aortic dissection (ATAAD) are considered high - risk or inoperable. This study aims to investigate the early and mid-term outcomes of complex endovascular aortic repair of aortic root, ascending aorta, and aortic arch among patients with ATAAD. ⋯ Early outcomes of complex endovascular repair of ascending aortic dissection are promising with acceptable mortality and stroke rate. However, the rate of endoleak after isolated ascending TEVAR with a tear within 2cm of the aortic root is high with poor long-term survival.
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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.
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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.