The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections.
Excessive fluid administration during lung resections is a risk for pulmonary injury. We analyzed the effect of intraoperative fluids on postoperative pulmonary complications (PCs). ⋯ The occurrence of postoperative PCs is seen more frequently if the intraoperative infusion rate of fluids exceeds 6 mL/kg/h.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Comparative StudyMinimally invasive transthoracic device closure of isolated ventricular septal defects without cardiopulmonary bypass: long-term follow-up results.
Minimally invasive transthoracic device closure (MITDC) of ventricular septal defects (VSD) under transesophageal echocardiography guidance is increasingly and successfully being performed with excellent results. We retrospectively reviewed 458 patients who received this treatment in our center and summarized the 6-year follow-up results. ⋯ MITDC of a VSD on a beating heart is a safe and effective alternative to conventional treatments. The 6-year clinical outcomes are promising. Modification of occluders and the delivery set play an important role in good outcomes.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Variation in transfusion rates within a single institution: exploring the effect of differing practice patterns on the likelihood of blood product transfusion in patients undergoing cardiac surgery.
Rates of perioperative transfusion vary widely among patients undergoing cardiac surgery. Few studies have examined factors beyond the clinical characteristics of the patients that may be responsible for such variation. The purpose of this study was to determine whether differing practice patterns had an impact on variation in perioperative transfusion at a single center. ⋯ Differing practice patterns contribute to significant variation in rates of perioperative transfusion within a single center. Strategies aimed at reducing overall transfusion rates must take into account such variability in practice patterns and account for nonclinical factors as well as known clinical predictors of blood transfusions.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Hybrid palliation for critical systemic outflow obstruction: neither rapid stage 1 Norwood nor comprehensive stage 2 mitigate consequences of early risk factors.
Hybrid palliation with branch pulmonary artery banding (bPAB) has become increasingly common in the early management of patients with critical left ventricular outflow obstruction. Optimal subsequent surgical palliation remains undefined. ⋯ Both St1N and CompSt2 are viable options for subsequent palliation following initial hybrid procedure. Transplant-free survival and eventual Fontan candidacy are similar between groups. Delaying surgical palliation with the CompSt2 did not mitigate the impact of early risk factors such as low birth weight and aortic atresia.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Comparative StudyEarly and late outcomes of acute type A aortic dissection with intramural hematoma.
Controversy remains regarding management of acute type A dissection with intramural hematoma (IMH). Our purpose was to analyze our experience and report outcomes after repair of acute type A aortic dissection with IMH. ⋯ Repair of acute type A aortic dissection with IMH is associated with significant early morbidity and mortality, differing minimally from typical aortic dissection. Although expectant repair within 3 days may be applied, the purposeful delay imparted little advantage. Improved late outcomes may be seen with IMH, but continued long-term surveillance is required for verification.