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The Society of Thoracic Surgeons 2018  Adult Cardiac Surgery Risk Models: Part 2—Statistical Methods and Results
Conclusions New STS ACSD risk models have generally excellent calibration and discrimination and are well suited for risk adjustment of STS performance metrics.
Source: The Annals of Thoracic Surgery - April 22, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Determinants of Reverse Remodeling of the Left Atrium Following Transaortic Myectomy
Conclusions Left atrial volume decreases significantly following surgical relief of left ventricular outflow tract obstruction. Early changes likely reflect lower LA pressure due to gradient relief and abolishment of mitral regurgitation, and late reduction suggests continued reverse remodeling.
Source: The Annals of Thoracic Surgery - April 20, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Reoperation Following Stentless Bioprosthesis: Short- and Long-Term Outcomes
Conclusions Aortic valve reoperation following stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
Source: The Annals of Thoracic Surgery - April 4, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Revascularization with Single Versus Bilateral Mammary Arteries: Is It Time to Change?
Conclusions In a large regional experience BIMA is associated with no upfront risk of adverse events and improved long-term survival compared to SIMA. Our results indicate that BIMA conduits should be considered more frequently during CABG due to their demonstrated survival advantage.
Source: The Annals of Thoracic Surgery - March 15, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Durability of Aortic Valve Cusp Repair With and Without Annular Support
Conclusions Valve repair is effective and durable for treating aortic valve dysfunction. Greater severity of AR preoperatively is associated with higher likelihood of repair failure. Commissural figure-of-8 suspension sutures and repair with annular support have the best long-term durability.
Source: The Annals of Thoracic Surgery - February 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac Surgery Outcomes in Abdominal Solid Organ Transplant Recipients
Conclusions Previous history of abdominal transplant is associated with an increased 30-day incidence of stroke after cardiac surgery. Abdominal transplant does not affect 30-day mortality after cardiac surgery, whereas long-term survival is significantly reduced. Regular patient follow-up and prevention and early treatment of postoperative complications are key to patient survival.
Source: The Annals of Thoracic Surgery - February 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sixteen-Year Experience of David and Bentall Procedures in Acute Type A Aortic Dissection
Conclusions Both the David and Bentall procedures are appropriate surgical approaches for aortic root replacement in select patients with an acute type A aortic dissection.
Source: The Annals of Thoracic Surgery - February 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparison of Endoaortic and Transthoracic Aortic Clamping in Less-Invasive Mitral Valve Surgery
Conclusions Despite recent concerns arising about EAC, this large multicenter study shows equivalence in terms of safety and effectiveness of this technique compared with TTC. Reduction in postoperative bleeding was observed in the EAC group despite the higher rate of complex redo cases.
Source: The Annals of Thoracic Surgery - February 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Development of a Risk Prediction Model and Clinical Risk Score for Isolated Tricuspid Valve Surgery
Conclusions Mortality and major morbidity after isolated TV surgery can be predicted using preoperative patient data from the STS Adult Cardiac Database. A simple clinical risk score predicts mortality and major morbidity after isolated TV surgery. This score may facilitate perioperative counseling and identification of suitable patients for TV surgery.
Source: The Annals of Thoracic Surgery - February 3, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Pectus Excavatum on Cardiopulmonary Function
Conclusions The inspiratory HI and CI reflect the effect of pectus excavatum on cardiopulmonary function. The cardiopulmonary system reacts first with an increase in heart rate at anaerobic threshold, followed by a decrease in stroke volume at anaerobic threshold and maximum stroke volume. Increased severity of the deformity then leads to a decrease in cardiac output.
Source: The Annals of Thoracic Surgery - January 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Direct Aortic Access for Transcatheter Aortic Valve Replacement Using a Self-Expanding Device
Conclusions When femoral access is not feasible, DA access allows effective delivery of the valve but incurs an increased risk of death and adverse events, potentially the result of procedural differences.
Source: The Annals of Thoracic Surgery - January 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Retrograde Cerebral Perfusion Is Effective for Prolonged Circulatory Arrest in Arch Aneurysm Repair
Conclusions RCP is an effective adjunctive cerebral protection strategy for complex aortic arch aneurysm repair with prolonged DHCA and is not associated with increased death or neurologic complications.
Source: The Annals of Thoracic Surgery - January 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Safety of Moderate Hypothermia With Antegrade Cerebral Perfusion in Total Aortic Arch Replacement
Conclusions In this series, TOTAL with MHCA and ACP can be safely performed with acceptable operative risk. MHCA and ACP represent an effective strategy for TOTAL and may obviate the need for DHCA.
Source: The Annals of Thoracic Surgery - December 10, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Bilateral Internal Thoracic Artery Grafts in Hemodialysis: A Single-Center Propensity Score Analysis
Conclusions CABG using BITA grafts showed no advantages in midterm outcome among hemodialysis patients; however, there were no adverse effects on perioperative morbidity or death. For hemodialysis patients with limited available conduits, BITA may be an important option for multivessel revascularization.
Source: The Annals of Thoracic Surgery - December 10, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Evolution of Simplified Frozen Elephant Trunk Repair for Acute DeBakey Type I Dissection: Midterm Outcomes
Conclusions Simplified FET for treating acute DeBakey type I dissection has evolved and remained safe. It promotes aortic remodeling, and simplifies management of chronic aortic complications.
Source: The Annals of Thoracic Surgery - December 6, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

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