The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2016
Randomized Controlled Trial Multicenter Study Comparative StudyProsthesis-patient mismatch in high-risk patients with severe aortic stenosis: A randomized trial of a self-expanding prosthesis.
We compared the incidence of prosthesis-patient mismatch (PPM) between transcatheter aortic valve replacement (TAVR) using a self-expanding bioprosthesis and surgical aortic valve replacement (SAVR) in the CoreValve US High Risk Pivotal Trial. We sought to determine the influence of PPM on clinical outcomes. ⋯ In patients with high surgical risk and severe aortic stenosis, severe PPM is more common in patients treated with SAVR than those treated with TAVR. Patients with severe PPM are a greater risk for death and acute kidney injury than patients without severe PPM.
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J. Thorac. Cardiovasc. Surg. · Apr 2016
Editorial ReviewThe American Association for Thoracic Surgery Consensus Guidelines: Reasons and purpose.
The time interval for the doubling of medical knowledge continues to decline. Physicians, patients, administrators, government officials, and payors are struggling to keep up to date with the waves of new information and to integrate the knowledge into new patient treatment protocols, processes, and metrics. Guidelines, Consensus Guidelines, and Consensus Statements, moderated by seasoned content experts, offer one method to rapidly distribute new information in a timely manner and also guide minimal standards of treatment of clinical care pathways as they are developed as part of bundled care programs. These proposed Consensus Guidelines advance The American Association for Thoracic Surgery's mission of leading in cardiothoracic health care, education, innovation, and modeling excellence.
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J. Thorac. Cardiovasc. Surg. · Apr 2016
Editorial ReviewThe present day potential role of fractional flow reserve-guided coronary artery bypass graft surgery.
The favorable impact of fractional flow reserve measurements on the decision-making and overall outcomes of percutaneous coronary artery intervention is well established. However, the clinical application of fractional flow reserve in surgical revascularizations is still debated. The purpose of this article is to provide a comprehensive review on the current potential role of fractional flow reserve guidance in coronary artery bypass grafting.
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J. Thorac. Cardiovasc. Surg. · Apr 2016
Multicenter StudyIncidence and implications of postoperative supraventricular tachycardia after pulmonary lobectomy.
We sought to determine the rate of postoperative supraventricular tachycardia (POSVT) in patients undergoing pulmonary lobectomy, and its association with adverse outcomes. ⋯ POSVT is common in patients undergoing pulmonary lobectomy and is associated with adverse outcomes. Comparative studies are needed to determine whether strict adherence to recently published guidelines will decrease the rate of stroke, readmission, and death after POSVT in thoracic surgical patients.
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J. Thorac. Cardiovasc. Surg. · Apr 2016
Review Case ReportsExtracorporeal life support during pregnancy.
To review the literature on extracorporeal life support (ECLS) during pregnancy to determine its efficacy and safety for the mother and fetus. ⋯ ECLS during pregnancy is effective and relatively safe for the mother and fetus. The first successful use of ECLS in a pregnant patient with life-threatening hantavirus cardiopulmonary syndrome is being reported together with this review.