The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2024
Can We Safely Expand the DCD Donor Heart Pool by Extending the Donor Age Limit?
This study evaluates the impact of donor age on outcomes following donation after circulatory death heart transplantation. ⋯ The use of appropriately selected donation after circulatory donors aged 40 years or more has similar survival compared with that of younger donors. With careful candidate risk stratification and selection, consideration of using donation after circulatory donors aged more than 40 years may further ameliorate ongoing organ shortage with comparable early post-transplant outcomes.
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J. Thorac. Cardiovasc. Surg. · Apr 2024
Surgical versus Transcatheter Aortic Valve Replacement in Low Risk Medicare Beneficiaries.
Recent approval of transcatheter aortic valve replacement (TAVR) in patients at low surgical risk has resulted in a rapid real-world expansion of TAVR in patients not otherwise examined in recent low-risk trials. We sought to evaluate the outcomes of surgical aortic valve replacement (SAVR) versus TAVR in low-risk Medicare beneficiaries. ⋯ Among low-risk Medicare beneficiaries younger than age 75 years undergoing isolated AVR, SAVR was associated with higher index morbidity and mortality but improved 3-year risk-adjusted stroke, valve reintervention, and survival compared with TAVR.
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J. Thorac. Cardiovasc. Surg. · Apr 2024
Transcatheter versus Surgical Aortic Valve Replacement for Severe Aortic Valve Stenosis: Meta-Analysis with Trial Sequential Analysis.
Randomized controlled trials comparing transcatheter aortic valve implantation with surgical aortic valve replacement demonstrate conflicting evidence, particularly in low-risk patients. We aim to reevaluate the evidence using trial sequential analysis, balancing type I and II errors, and compare with conventional meta-analysis. ⋯ Conventional meta-analysis methods may have prematurely declared an early reduction of negative outcomes after transcatheter aortic valve implantation when compared with surgical aortic valve replacement.
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J. Thorac. Cardiovasc. Surg. · Apr 2024
EditorialARTIFICIAL INTELLIGENCE: THE FUTURE OF CARDIOTHORACIC SURGERY.
Artificial intelligence (AI) is a rapidly emerging field of computer science with a significant predicted impact in cardiothoracic surgery. We investigate the role of this tool in the preoperative planning, intraoperative assistance, and postoperative management of patients. We also describe the future applications in the field and provide an insight on the advancements we have made at our institution. ⋯ The integration of AI in cardiothoracic surgery represents a paradigm shift in clinical medicine. The transformative potential is evident in the ability to improve diagnosis and risk assessment, make personalized treatment plans, and aid in surgical decision making. While the results are undoubtedly promising, addressing ethical concerns and patient privacy is paramount to maintain a balance for success. As we navigate these challenges, the future of cardiothoracic surgery looks bright with more effective, efficient, and patient-centric practices on the horizon.