The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Randomized Controlled Trial Multicenter StudyTechnical performance score is associated with outcomes after the Norwood procedure.
The technical performance score (TPS) has been reported in a single center study to predict the outcomes after congenital cardiac surgery. We sought to determine the association of the TPS with outcomes in patients undergoing the Norwood procedure in the Single Ventricle Reconstruction trial. ⋯ TPS is an independent predictor of important outcomes after Norwood and could serve as a tool for quality improvement.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyIncidence and outcomes of right-sided endocarditis in patients with congenital heart disease after surgical or transcatheter pulmonary valve implantation.
To evaluate right-sided endocarditis and compare the incidence, clinical presentations, and outcomes in patients with a surgical and percutaneous pulmonary valve. ⋯ There is a higher incidence of endocarditis in patients with PPVI compared with surgical pulmonary valves. Clinical and biological features were comparable in both groups. The role of bovine jugular veins in the development of endocarditis is concerning. However, despite a higher incidence of endocarditis in the PPVI group, the probabilities of survival and event-free survival were similar to the surgical group.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Multicenter StudyPredictors of 90-day mortality after congenital heart surgery: the first report of risk models from a Japanese database.
The purpose of this study was to develop risk models for congenital heart surgery short-term and midterm outcomes from a nationwide integrated database drawn from hospitals in Japan. ⋯ The proposed risk scores and categories have high discrimination power for predicting mortality, demonstrating improvement relative to existing consensus-based methods. Risk models incorporating these measures may be useful for comparing mortality outcomes cross institutions or countries with mixed cases.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyImplementation of bundled interventions greatly decreases deep sternal wound infection following cardiovascular surgery.
Surgical site infection (SSI), particularly deep sternal wound infection (DSWI), is a serious complication after cardiovascular surgery because of its high mortality rate. We evaluated the effectiveness of an SSI bundle to reduce DSWI and identify the risk factors for DSWI. ⋯ Complete implementation of simple multidisciplinary prevention measures as a bundle can greatly decrease the incidence of DSWI.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Multicenter StudyRisk factors for mortality and failure of conservative treatment after aortic type B dissection.
Despite medical treatment, one third of patients with uncomplicated type B aortic dissections experience severe late complications. The aim of this study was to identify patients at high risk of mortality during follow-up. ⋯ Our study revealed both early aortic dilatation and older age as risk factors for increased mortality after conservative treatment of type B dissection.