The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2023
Randomized Controlled TrialRenal perfusion with histidine-tryptophan-ketoglutarate compared with Ringer's solution in patients undergoing thoracoabdominal aortic open repair.
The objective of this study was to compare the efficacy of renal perfusion with Custodiol (Dr Franz-Kohler Chemie GmbH, Bensheim, Germany) versus enriched Ringer's solution for renal protection in patients undergoing open thoracoabdominal aortic aneurysm (TAAA) repair. ⋯ The use of Custodiol during open TAAA repair was safe and resulted in significantly lower rates of postoperative AKI compared with Ringer's solution. These findings support safety and efficacy of Custodiol in this specific setting, which is currently off-label.
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J. Thorac. Cardiovasc. Surg. · Feb 2023
Randomized Controlled TrialOxygen delivery-guided perfusion for the prevention of acute kidney injury: A randomized controlled trial.
The reduction of postoperative acute kidney injury in patients undergoing cardiopulmonary bypass surgery using an oxygen delivery-guided perfusion strategy (oxygen delivery strategy) for cardiopulmonary bypass management compared with a fixed flow perfusion (conventional strategy) remains controversial. The purpose of this study was to determine whether a oxygen delivery strategy would reduce the incidence of postoperative acute kidney injury in patients undergoing cardiopulmonary bypass surgery. ⋯ An oxygen delivery strategy for cardiopulmonary bypass management was superior to a conventional strategy with respect to preventing the development of acute kidney injury.
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J. Thorac. Cardiovasc. Surg. · Feb 2023
Racial and ethnic variation in referral times for thoracic oncologic surgery in a major metropolitan area.
The study objective was to understand the impact of race/ethnicity on access to thoracic surgical care for patients undergoing lung resection for cancer. ⋯ Discussion of how race and ethnicity impact referral time to thoracic surgery discussed by Dr Moises Hernandez.
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J. Thorac. Cardiovasc. Surg. · Feb 2023
Machine learning-based radiomic computed tomography phenotyping of thymic epithelial tumors: Predicting pathological and survival outcomes.
For patients with thymic epithelial tumors, accurately predicting clinicopathological outcomes remains challenging. We aimed to investigate the performance of machine learning-based radiomic computed tomography phenotyping for predicting pathological (World Health Organization [WHO] type and TNM stage) and survival outcomes (overall and progression-free survival) in patients with thymic epithelial tumors. ⋯ Machine learning-based radiomic computed tomography phenotyping might allow for the satisfactory prediction of pathological and survival outcomes and further improve prognostic performance when integrated with clinicopathological features in patients with thymic epithelial tumors.
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J. Thorac. Cardiovasc. Surg. · Feb 2023
Prosthetic choice in mitral valve replacement for severe chronic ischemic mitral regurgitation: Long-term follow-up.
Prosthetic choice for mitral valve replacement is generally driven by patient age and patient and surgeon preference, and current guidelines do not discriminate between different etiologies of mitral valve disease. Our objective was to assess and compare short- and long-term outcomes after mitral valve replacement among patients with biological or mechanical prostheses in the setting of severe ischemic mitral regurgitation. ⋯ The type of prosthesis has no influence on long-term survival among patients with severe ischemic mitral regurgitation undergoing mitral valve replacement. There may be an increased risk of neurologic events and serious bleeding associated with mechanical prostheses.