The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Reversibility of Precapillary Pulmonary Hypertension and Outcomes After Heart Transplantation Bridged with Left Ventricular Assist Devices: Insight from the UNOS.
In light of the updated lowered threshold for diagnosing pulmonary hypertension (PH), the reversibility of precapillary PH with left ventricular assist device (LVAD) and the associated post-heart transplantation (HT) outcomes remain unclear. ⋯ Many recipients of HT bridged with LVAD remain with PVR >2 after LVAD implantation, which is associated with increased risk of death after HT compared with patients with normalized PVR after LVAD.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Multicenter StudyLong-term outcomes after recurrent acute thoracic aortic dissection: Insights from the International Registry of Aortic Dissection.
With an aging population and advancements in imaging, recurrence of thoracic aortic dissection is becoming more common. ⋯ The case volume of recurrent dissection or the ability to detect recurrent dissection has increased over time. Acute type A recurrent dissection was associated with a higher risk of major aortic events than initial dissection. Further judicious follow-up may be crucial after type A recurrent dissection.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Interpretable Machine Learning-Based Predictive Modeling of Patient Outcomes Following Cardiac Surgery.
The clinical applicability of machine learning predictions of patient outcomes following cardiac surgery remains unclear. We applied machine learning to predict patient outcomes associated with high morbidity and mortality after cardiac surgery and identified the importance of variables to the derived model's performance. ⋯ A machine learning model accurately and reliably predicts patient outcomes following cardiac surgery. Postoperative, as opposed to preoperative or intraoperative variables, are important to model performance. Interventions targeting this period, including minimizing the duration of mechanical ventilation and early treatment of new-onset postoperative arrhythmias, may help lower the risk of these complications.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Outcomes Following Multivalve Reoperation in Adults with Congenital Heart Disease: A 30-Year, Single Center Study.
As patients with congenital heart disease increasingly live into adulthood, reoperative surgery is frequently required. Although half of these are valve-related procedures, little is known regarding early and late outcomes, and factors associated with adverse outcomes. ⋯ Multiple valve interventions are common and confer low early mortality in the elective setting. Referral before ventricular dysfunction and in an elective setting optimizes outcomes.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Outcomes of thoracoabdominal aortic aneurysm repair in patients with a prior myocardial infarction.
Many patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair have had a previous myocardial infarction (MI). To address the paucity of data regarding outcomes in such patients, we aimed to compare outcomes after open TAAA repair in patients with and without previous MI. ⋯ Although previous MI was not associated with early mortality after TAAA repair, patients with a previous MI had greater rates of cardiac complications and delayed paraparesis. Patients with a previous MI also trended toward poorer survival.