The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2024
Patient, facility, and surgical factors associated with significant delays to esophagectomy and subsequent poor outcomes: An analysis of 16,486 cases.
Delays to definitive surgery in esophageal cancer may be associated with disease progression and worsened survival. The objective of this study was to perform a national assessment for predictors of delay to esophagectomy and to assess for their impact on oncologic and survival outcomes. ⋯ After risk adjustment for patient, oncologic, facility, and surgical characteristics, there were several predictors of increased time to esophagectomy associated with consequences of upstaging and survival.
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J. Thorac. Cardiovasc. Surg. · Nov 2024
Impact of TAVR Utilization Ratio on Outcomes in Patients with Aortic Valve Disease.
Use of the Heart Team has been the standard of care for the treatment of aortic valve disease; however, its efficacy has not been evaluated. We sought to analyze its impact using the transcatheter aortic valve replacement (TAVR) use ratio (number of TAVR/total aortic valve replacement [AVR] volume) on TAVR, surgical aortic valve replacement (SAVR), and overall AVR outcomes. ⋯ Centers with balanced TAVR ratios had superior outcomes compared with centers with low or high ratios. These data support the use of a balanced Heart Team to optimize AVR outcomes.
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J. Thorac. Cardiovasc. Surg. · Nov 2024
Multicenter evaluation of patient safety incidents in lung surgery: The EPSI study.
To determine the incidence of patient safety incidents (PSIs) occurring during perioperative care for lung surgery and their influence on postoperative outcomes at 90 days. ⋯ Incidence of PSIs in thoracic surgery may occur in approximately one-third of procedures. Human factors play a crucial role in the occurrence of these PSIs.
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J. Thorac. Cardiovasc. Surg. · Nov 2024
Current outcomes of systemic-to-pulmonary artery shunt in patients with biventricular circulation.
This study investigated the outcomes after systemic-to-pulmonary artery shunt in patients with biventricular circulation. ⋯ In the current era, the systemic-to-pulmonary artery shunt is a safe and useful option for patients with biventricular circulation. In patients with risk factors for in-hospital major adverse shunt-related events, meticulous efforts should be directed toward preventing pulmonary overcirculation to further enhance outcomes.