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Does Mitral Valve Calcium In Patients Undergoing Mitral Valve Replacement Portend Worse Survival?
ConclusionsConservative approach to treat MAC achieves satisfactory results. Patients with MAC have significant comorbidities contributing to a worse survival though MAC in itself is not a risk factor for mortality.
Source: The Annals of Thoracic Surgery - November 3, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Outcomes of Mitral Valve Reoperations in the United States: An Analysis of the Society of Thoracic Surgeons National Database
ConclusionsDespite a high-risk patient profile, surgical outcomes of reoperative MVS were acceptable, particularly in elective cases with prior mitral valve surgery and without endocarditis.
Source: The Annals of Thoracic Surgery - October 24, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 Years and Younger
ConclusionsThe increased risk of reoperation for bAVR and major bleeding incidents for mAVR was not reflected in midterm and long-term survival differences between the two groups. Our results suggest that bAVR may be an acceptable prosthesis choice for some patients aged 50 years and younger, although the results should be taken with caution.Visual Abstract
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Bilateral Internal Mammary Artery Use in Diabetic Patients: Friend or Foe?
ConclusionsIn this statewide analysis, diabetic patients who received BIMA grafts (compared with diabetic patients with LIMA grafts or nondiabetic patients with BIMA grafts) had higher O/E ratios for composite morbidity/mortality as a result of higher O/E ratios for major complications.
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Salvage Coronary Artery Bypass Predicts Increased Mortality during Aortic Root Surgery
ConclusionsCABG during ROOT results in increases in postoperative morbidity or mortality compared with isolated ROOT. Outcomes, however, are influenced by the specific clinical indication. CABG for CAD was associated with similar outcomes compared with isolated ROOT. Patients undergoing unplanned CABG for acute ventricular failure had the worst outcomes, thus underscoring the importance of technical success during coronary reimplantation.
Source: The Annals of Thoracic Surgery - August 29, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemiarch Reconstruction Versus Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm
ConclusionsHemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared with a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multiprocedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Programmatic and Surgeon Specialization Improves Mortality in Isolated Coronary Bypass Grafting
ConclusionsSubspecialization in CABG and dedicated coronary surgery programs may lead to faster operations, increased use of bilateral internal mammary arteries, fewer complications, and improved survival after isolated CABG.
Source: The Annals of Thoracic Surgery - July 26, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Reoperation After Stentless Bioprosthesis: Short- and Long-Term Outcomes
ConclusionsAortic valve reoperation after stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
Source: The Annals of Thoracic Surgery - July 23, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Revascularization With Single Versus Bilateral Mammary Arteries: Is It Time to Change?
ConclusionsIn a large regional experience, BIMA is associated with no upfront risk of adverse events and improved long-term survival compared with SIMA. Our results indicate that BIMA conduits should be considered more frequently during coronary artery bypass grafting due to their demonstrated survival advantage.
Source: The Annals of Thoracic Surgery - July 23, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Bilateral Internal Mammary Artery Utilization in Diabetics: Friend or Foe?
Conclusions In this statewide analysis, diabetics who received BIMA grafts (compared to diabetics with LIMA grafts or non-diabetics with BIMA grafts) had higher O/E ratios for composite morbidity/mortality as a result of higher O/E ratios for major complications.
Source: The Annals of Thoracic Surgery - June 20, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemiarch Reconstruction Vs Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm
Conclusions Hemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared to a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multi-procedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery.
Source: The Annals of Thoracic Surgery - May 4, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hybrid Coronary Revascularization Versus On-Pump Coronary Artery Bypass Grafting
Conclusions For selected patients, HCR is associated with a faster postoperative recovery as well as similar short-term and long-term outcomes when compared with standard on-pump CABG.
Source: The Annals of Thoracic Surgery - April 22, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-Term Survival Prediction for Coronary Artery Bypass Grafting: Validation of the ASCERT Model Compared With The Society of Thoracic Surgeons Predicted Risk of Mortality
Conclusions The ASCERT survival probability calculator was externally validated for prediction of long-term survival after coronary artery bypass grafting in all risk groups. The widely used STS PROM performed comparably as a predictor of long-term survival. Both tools provide important information for preoperative decision making and patient counseling about potential outcomes after coronary artery bypass grafting.
Source: The Annals of Thoracic Surgery - April 22, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Society of Thoracic Surgeons 2018 Adult Cardiac Surgery Risk Models: Part  1—Background, Design Considerations, and Model Development
Conclusions Completely new STS ACSD risk models have been developed based on contemporary patient data; their performance is superior to that of previous STS ACSD models.
Source: The Annals of Thoracic Surgery - April 22, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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

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