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The Impact of Preoperative Clopidogrel on Outcomes After Coronary Artery Bypass Grafting
ConclusionsCABG can be safely performed in patients with recent clopidogrel exposure with no increased risk of early or late mortality. However, CABG should be delayed for at least 5 days, if clinically feasible, to minimize transfusions and reoperation risk. In patients with more urgent indications, delaying CABG at least 3 days can mitigate but not eliminate the increased bleeding risk.
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Results of left ventricular reconstruction with and without mitral valve surgery
ConclusionsThe clinical outcomes of left ventricular reconstruction are comparable to those of left ventricular reconstruction plus mitral valve surgery in patients with left aneurysm and moderate mitral regurgitation.
Source: The Annals of Thoracic Surgery - August 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Failure to rescue contributes to center-level differences in mortality after lung transplantation
ConclusionsDifferences in rates of Failure to Rescue contribute significantly to per-center variability in mortality following LTx. FTR can serve as a quality metric to identify opportunities for improvement in management of perioperative adverse events.
Source: The Annals of Thoracic Surgery - August 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemolysis and Nonhemorrhagic Stroke During Venoarterial Extracorporeal Membrane Oxygenation
ConclusionsHemolysis at low levels during VA ECMO support is associated with subsequent nonhemorrhagic stroke.
Source: The Annals of Thoracic Surgery - August 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Survival After Myectomy for Obstructive Hypertrophic Cardiomyopathy: What Causes Late Mortality?
ConclusionsThis study, using 2 independent sources to verify vital status and cause of mortality, confirms that survival after septal myectomy is excellent. Hypertrophic cardiomyopathy was identified as the primary cause of death in less than 20%, with mortality in most patients unrelated to hypertrophic cardiomyopathy.
Source: The Annals of Thoracic Surgery - August 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Epiaortic Ultrasound to Prevent Stroke in Coronary Artery Bypass Grafting
ConclusionsAvoiding aortic manipulation is associated with the lowest risk of stroke in patients undergoing CABG. When manipulation of the ascending aorta is planned, EAU is effective in guiding the surgical strategy to reduce the risk for embolic stroke in these patients.
Source: The Annals of Thoracic Surgery - August 15, 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

Physician-Modified Thoracic Stent Grafts for the Arch After Surgical Treatment of Type A Dissection
ConclusionsThe use of physician-modified thoracic stent grafts for the treatment of dissecting aortic arch aneurysm after surgical treatment of acute type A dissection is feasible and effective. Durability concerns will need to be assessed in future studies.Visual Abstract
Source: The Annals of Thoracic Surgery - July 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term outcomes of stand-alone Maze IV for persistent/long-standing persistent atrial fibrillation
ConclusionsThis study confirmed the safety and efficacy at long-term (7 years) of the stand-alone Maze IV surgical procedure for persistent/long-standing persistent AF. Indeed, more than 70% of the pts were in SR off class I/III AADs and off oral anticoagulation.Graphical abstract
Source: The Annals of Thoracic Surgery - July 18, 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

Comparative Outcomes of Transcarotid and Trans-subclavian Transcatheter Aortic Valve Replacement
ConclusionsThe transcarotid and the trans-subclavian approaches have similar safety and efficacy outcomes. The transcarotid approach had a shorter procedure duration and a trend towards lower fluoroscopy duration and radiation exposure.
Source: The Annals of Thoracic Surgery - July 4, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Novel Formula to calculate 3-D Angle between Inflow Cannula and Device Body of HeartMate II LVAD
ConclusionsWe established a novel formula to mathematically calculate actual 3D angles between inflow cannula and device body of HeartMate II. The formula would help investigators to validate their findings of the relationship between 2D projected angle (from CXR) and device thrombosis.
Source: The Annals of Thoracic Surgery - June 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Preoperative anemia and outcomes in cardiovascular surgery: systematic review and meta-analysis
ConclusionsPreoperative anemia is associated with adverse outcomes following cardiac surgery. These findings support the addition of preoperative anemia to future risk prediction models, and as a target for risk modification.
Source: The Annals of Thoracic Surgery - June 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Steps forward in minimally invasive cardiac surgery: 10-year experience
ConclusionsThe present study shows the considerable and attractive results of our decision making process based on the tailored approach: the 10-year outcome analysis demonstrates a trend toward a progressive decrease in the overall rate of post-operative complications and a significant protective effect of the tailored approach on the occurrence of stroke.
Source: The Annals of Thoracic Surgery - June 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Characterizing Risks Associated with Mitral Annular Calcification in Mitral Valve Replacement
ConclusionsThe presence of MAC alone, regardless of severity, was independently associated with increased operative mortality and adverse postoperative outcomes. Even after adjusting for attendant cardiovascular and metabolic comorbidities, centers with low MV case volumes were found to have worse outcomes after MVR.Graphical abstract
Source: The Annals of Thoracic Surgery - June 15, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

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