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Mitigating the Risk: Transfusion or Reoperation for Bleeding After Cardiac Surgery
ConclusionsWhile reoperation for bleeding is associated with morbidity after cardiac surgery, substantial transfusion without reoperation appears to increase morbidity compared to a limited-transfusion reoperative approach. Better timing for reoperation and guided transfusion approaches may mitigate morbidity compared to substantial transfusion alone.
Source: The Annals of Thoracic Surgery - December 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications After Cardiac Operation on One-Year Patient-Reported Outcomes
ConclusionsAlthough cardiac surgical patients have PROs scores similar to the general population, complications after cardiac operation continue to negatively influence patient quality of life 1 year after surgery. Use of NIH-PROMIS shows that prolonged ventilation and renal failure have the largest impact on 1-year patient-reported outcomes.
Source: The Annals of Thoracic Surgery - December 14, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Replacement in Bioprosthetic Failure:Insights from The Society of Thoracic Surgeons National Database
ConclusionsThe number of patients undergoing SAVR for degenerated bioprosthesis is decreasing in U.S, particularly among older and high-risk patients. These trends may reflect the adoption of valve-in-valve transcatheter aortic valve replacement for degenerated bioprosthesis after its FDA approval in 2015.
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Increased Glucose Variability Is Associated With Major Adverse Events After Coronary Artery Bypass
ConclusionsIncreased 24-hour, but not 12-hour, postoperative GV following CABG is a predictor of poor outcomes. Preoperative HbA1c is not associated with MAEs after adjusting for postoperative mean glucose and GV.Graphical abstract
Source: The Annals of Thoracic Surgery - August 7, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications After Cardiac Surgery on One-Year Patient Reported Outcomes
ConclusionsWhile cardiac surgical patients have PRO scores similar to the general population, complications after cardiac surgery continue to negatively influence patient quality of life one-year after surgery. Using the NIH-PROMIS, prolonged ventilation and renal failure have the largest impact on one-year patient reported outcomes.
Source: The Annals of Thoracic Surgery - July 16, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Model for End-Stage Liver Disease Score Independently Predicts Mortality in Cardiac Surgery
ConclusionsIncreasing MELD score, international normalized ratio, and bilirubin all independently increase risk of operative mortality. Because high rates of missing data currently limit utilization of MELD, efforts to simplify and improve data collection would help improve future risk models.
Source: The Annals of Thoracic Surgery - May 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications on Resource Utilization During 90-Day Coronary Artery Bypass Graft Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries who have adverse events during their index CABG hospitalization will significantly affect that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and manage the services consumed by Medicare beneficiaries having adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - April 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Complete Sternal-Sparing HeartMate 3 Implantation: A Case Series of 10 Consecutive Patients
ConclusionsOur early outcomes suggest that the CSS approach may reduce the incidence of right ventricular failure, bleeding, intubation time, and intensive care unit length of stay. Further studies are needed to fully elucidate the advantages of CSS LVAD implantation compared with median sternotomy.
Source: The Annals of Thoracic Surgery - March 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Deep Hypothermia With Retrograde Cerebral Perfusion Versus Moderate Hypothermia With Antegrade Cerebral Perfusion for Arch Surgery
ConclusionsAlthough there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
Source: The Annals of Thoracic Surgery - March 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Risk Prediction Model for Major Adverse Outcome in Proximal Thoracic Aortic Surgery
ConclusionsThe current study identified risk factors for major adverse outcome after proximal thoracic aortic surgery with hypothermic circulatory arrest for degenerative pathology. The proposed simple, accurate model can quantify risk and facilitate physician-patient counseling before possible surgical intervention.
Source: The Annals of Thoracic Surgery - February 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve-Sparing Root Replacement Provides Excellent Midterm Outcomes for Bicuspid Valve Aortopathy
ConclusionsVSRR can be safely and effectively performed in young patients with bicuspid valve anatomy regardless of degree of preoperative AI. Valve function is durable and the incidence of valve-related complications is low. VSRR is an attractive and potentially superior option to conventional root replacement in appropriately selected patients with bicuspid aortopathy.Visual Abstract
Source: The Annals of Thoracic Surgery - January 26, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Extubation Without Increased Adverse Events in High-Risk Cardiac Surgical Patients
ConclusionsA prudent and diligent multifaceted early extubation protocol may be successful in high-risk cardiac surgical patients without an increase in adverse outcomes. A larger study is needed in the future to confirm the finding.
Source: The Annals of Thoracic Surgery - January 26, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Model for End Stage Liver Disease Score Independently Predicts Mortality in Cardiac Surgery
ConclusionsIncreasing MELD score, INR, and bilirubin all independently increase risk of operative mortality. Since high rates of missing data currently limit utilization of MELD, efforts to simplify and improve data collection would help improve future risk models.
Source: The Annals of Thoracic Surgery - January 10, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications on Resource Utilization during 90-day CABG Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries that experience adverse events during their index CABG hospitalization will significantly impact that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and managing the services consumed by Medicare beneficiaries experiencing adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - December 14, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Deep Hypothermia + Retrograde Cerebral Perfusion vs. Moderate Hypothermia + Antegrade Cerebral Perfusion for Arch Surgery
ConclusionsAlthough there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
Source: The Annals of Thoracic Surgery - November 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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