The Journal of thoracic and cardiovascular surgery
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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
Disparities in 180-day Infection Rates Following Coronary Artery Bypass Grafting and Aortic Valve Replacement.
To compare sex and racial differences in 180-day infection rates after coronary artery bypass grafting (CABG) and aortic valve replacement (AVR). ⋯ This multi-center study identified a 1.6-fold higher odds of infection among female patients. Non-Black female versus male patients had a 63% higher odds of infection. Transdisciplinary collaborative learning interventions should be considered to address these known disparities in infection rates.
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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.