The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Multicenter StudyTracheoplasty should be proactively considered within the surgical strategy for treating the ring-sling complex.
To examine the safety and effectiveness of proactive tracheoplasty for pediatric ring-sling complex. ⋯ Concurrent sling and tracheal surgeries for children with the ring-sling complex are safe and effective and are especially preferable for those with NWR ≤0.6, long-segment or diffuse tracheal stenosis, anomalous tracheobronchial arborization, and pronounced respiratory symptoms.
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Multicenter StudyLong-term outcomes after aortic root replacement for bicuspid aortic valve-associated aneurysm.
Patients with congenital bicuspid aortic valve often require root replacement. This study aims to describe their long-term rates of mortality and reoperation. ⋯ Patients who undergo aortic root replacement with bicuspid aortic valve have an increased rate of aortic reoperation (35%; 95% CI, 23%-46%) while their survival appears to be comparable to the general US population (79%; 95% CI, 73%-87%) at 15 years.
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Multicenter Study Comparative StudyEvaluation of sex differences in the receipt of concomitant atrial fibrillation procedures during non-mitral cardiac surgery.
Women are less likely to receive guideline-recommended cardiovascular care, but evaluation of sex-based disparities in cardiac surgical procedures is limited. Receipt of concomitant atrial fibrillation (AF) procedures during nonmitral cardiac surgery was compared by sex for patients with preoperative AF. ⋯ Women are less likely to receive guideline recommended concomitant AF procedure during nonmitral surgery. Identification of barriers to concomitant AF procedure in women may improve treatment of AF.
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Multicenter Study Comparative StudyWhat Drives Variability in Postoperative Cardiac Surgery Transfusion Rates?
Wide interhospital variation exists in cardiac surgical postoperative transfusion rates. We aimed to compare transfusion rates at 2 hospitals and identify the institutional practice factors, unrelated to patient or operative characteristics, associated with postoperative transfusion rates. ⋯ Variation in transfusion rates between hospitals H and L resulted from strict adherence at hospital L to a transfusion trigger of <6 g/dL with narrow indications for transfusions above that Hb concentration.
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Randomized Controlled Trial Multicenter StudyEfficacy and safety of macitentan in Fontan-palliated patients: 52-week randomized, placebo-controlled RUBATO phase 3 trial and open-label extension.
The efficacy and safety of macitentan, an endothelin receptor antagonist, were assessed in a 52-week, prospective, multicenter, double-blind, randomized, placebo-controlled, parallel-group study assessing the efficacy and safety of macitentan in Fontan-palliated adult and adolescent patients (RUBATO-DB) and an open-label extension trial (RUBATO-OL). ⋯ The primary end point of RUBATO-DB was not met; macitentan did not improve exercise capacity versus placebo in patients with Fontan palliation. Macitentan was generally well tolerated over long-term treatment.