Pub Date : 2024-04-01DOI: 10.1016/j.jtcvs.2024.04.003
J. Nelson
{"title":"Commentary: More is More?","authors":"J. Nelson","doi":"10.1016/j.jtcvs.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.04.003","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.jtcvs.2024.04.019
Maximilian A. Fliegner, H. Hou, Tyler M Bauer, Temilolaoluwa Daramola, Jeffrey McCullough, Francis D. Pagani, Devraj Sukul, D. Likosky, S. Keteyian, Mike P Thompson
{"title":"Interhospital Variability in Cardiac Rehabilitation Use After Cardiac Surgery Among Medicare Beneficiaries.","authors":"Maximilian A. Fliegner, H. Hou, Tyler M Bauer, Temilolaoluwa Daramola, Jeffrey McCullough, Francis D. Pagani, Devraj Sukul, D. Likosky, S. Keteyian, Mike P Thompson","doi":"10.1016/j.jtcvs.2024.04.019","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.04.019","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.jtcvs.2024.03.016
{"title":"Discussion to: What drives variability in postoperative transfusion rates?","authors":"","doi":"10.1016/j.jtcvs.2024.03.016","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.03.016","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.jtcvs.2024.04.014
Robert B. Hawkins
{"title":"Commentary: What Matters More: Method of Revascularization or Completeness?","authors":"Robert B. Hawkins","doi":"10.1016/j.jtcvs.2024.04.014","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.04.014","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.jtcvs.2024.04.015
D. Hoganson, V. Govindarajan, Noah E. Schulz, Peter E. Hammer, R. Rathod, Christopher W. Baird
{"title":"Complex Patient with Azygos Continuation of the Inferior Vena Cava: Value of Flow Simulation.","authors":"D. Hoganson, V. Govindarajan, Noah E. Schulz, Peter E. Hammer, R. Rathod, Christopher W. Baird","doi":"10.1016/j.jtcvs.2024.04.015","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.04.015","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1016/j.jtcvs.2024.02.013
Igor Gosev, D. Pham, John Y. Um, A. Anyanwu, A. Itoh, K. Kotkar, Koji Takeda, Yoshifumi Naka, Matthias Peltz, Scott C. Silvestry, Gregory Couper, M. Leacche, Vivek Rao, Benjamin Sun, Ryan J. Tedford, N. Mokadam, Robert McNutt, Daniel Crandall, Mandeep R. Mehra, Christopher T. Salerno
{"title":"Ventricular Assist Device using a Thoracotomybased Implant Technique: Multi-center HeartMate 3 SWIFT Study","authors":"Igor Gosev, D. Pham, John Y. Um, A. Anyanwu, A. Itoh, K. Kotkar, Koji Takeda, Yoshifumi Naka, Matthias Peltz, Scott C. Silvestry, Gregory Couper, M. Leacche, Vivek Rao, Benjamin Sun, Ryan J. Tedford, N. Mokadam, Robert McNutt, Daniel Crandall, Mandeep R. Mehra, Christopher T. Salerno","doi":"10.1016/j.jtcvs.2024.02.013","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.02.013","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139890926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1016/j.jtcvs.2024.01.035
Ourania Preventza, Jaymie Henry, Lubna Khan, Lorraine D. Cornwell, Katherine H. Simpson, Subhasis Chatterjee, Hiruni S. Amarasekara, Marc R. Moon, Joseph S. Coselli
Objective
We evaluated community socioeconomic (CSE) factors in patients who had unplanned readmission after undergoing proximal aortic surgery (ascending aorta, aortic root, or arch).
Methods
Unplanned readmissions for any reason within 60 days of the index procedure were reviewed by race, acuity at presentation, and gender. We also evaluated 3 CSE factors: poverty, household income, and education. Kaplan-Meier survival curves were used to assess long-term survival differences by group (race, acuity, gender).
Results
Among 2406 patients who underwent proximal aortic surgery during the 20-year study period and were discharged alive, our team identified 146 (6.1%) unplanned readmissions. Compared with White patients, Black patients lived in areas characterized by more widespread poverty (20.8% vs 11.1%, p=.0003), lower income (42,776 vs 65,193 USD, p=.0007), and fewer residents with a high school diploma (73.7% vs 90.1%, p <.0001). Compared with patients whose index operation was elective, patients who had urgent or emergency index procedures lived in areas with lower income (54,425 vs 64,846 USD, p=.01) and fewer residents with a high school diploma (81.1% vs 89.2%, p=.005). CSE factors did not differ by gender. Four- and 6-year survival estimates were 63.1% and 63.1% for Black patients versus 89.1% and 83.0% for White patients (p=.0009). No significant differences by acuity or gender were found.
Conclusions
Among readmitted patients, Black patients and patients who had emergency surgery had less favorable CSE factors and poorer long-term survival. Earlier and more frequent follow-up in these patients should be considered. Developing off-campus clinics and specific post-discharge measures targeting these patients is important.
方法 我们按照种族、发病时的敏锐度和性别对指数手术后 60 天内因任何原因再次入院的患者进行了复查。我们还评估了 3 个 CSE 因素：贫困、家庭收入和教育程度。结果在 20 年的研究期间，2406 名患者接受了近端主动脉手术并活着出院，其中我们的团队发现了 146 例（6.1%）计划外再入院患者。与白人患者相比，黑人患者居住的地区贫困现象更普遍（20.8% vs 11.1%，p=.0003），收入更低（42776 美元 vs 65193 美元，p=.0007），拥有高中文凭的居民更少（73.7% vs 90.1%，p <.0001）。与选择性手术的患者相比，紧急或急诊手术的患者居住在收入较低的地区（54,425 美元 vs 64,846 美元，p=.01），拥有高中文凭的居民较少（81.1% vs 89.2%，p=.005）。CSE 因素在性别上没有差异。黑人患者的四年和六年存活率分别为 63.1% 和 63.1%，而白人患者分别为 89.1% 和 83.0%（p=.0009）。结论在再次入院的患者中，黑人患者和接受过急诊手术的患者的CSE因素较差，长期生存率也较低。应考虑更早、更频繁地对这些患者进行随访。针对这些患者发展校外诊所和特定的出院后措施非常重要。
{"title":"Unplanned readmissions, community socioeconomic factors, and their effects on long-term survival after complex thoracic aortic surgery","authors":"Ourania Preventza, Jaymie Henry, Lubna Khan, Lorraine D. Cornwell, Katherine H. Simpson, Subhasis Chatterjee, Hiruni S. Amarasekara, Marc R. Moon, Joseph S. Coselli","doi":"10.1016/j.jtcvs.2024.01.035","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.01.035","url":null,"abstract":"<h3>Objective</h3><p>We evaluated community socioeconomic (CSE) factors in patients who had unplanned readmission after undergoing proximal aortic surgery (ascending aorta, aortic root, or arch).</p><h3>Methods</h3><p>Unplanned readmissions for any reason within 60 days of the index procedure were reviewed by race, acuity at presentation, and gender. We also evaluated 3 CSE factors: poverty, household income, and education. Kaplan-Meier survival curves were used to assess long-term survival differences by group (race, acuity, gender).</p><h3>Results</h3><p>Among 2406 patients who underwent proximal aortic surgery during the 20-year study period and were discharged alive, our team identified 146 (6.1%) unplanned readmissions. Compared with White patients, Black patients lived in areas characterized by more widespread poverty (20.8% vs 11.1%, p=.0003), lower income (42,776 vs 65,193 USD, p=.0007), and fewer residents with a high school diploma (73.7% vs 90.1%, p <.0001). Compared with patients whose index operation was elective, patients who had urgent or emergency index procedures lived in areas with lower income (54,425 vs 64,846 USD, p=.01) and fewer residents with a high school diploma (81.1% vs 89.2%, p=.005). CSE factors did not differ by gender. Four- and 6-year survival estimates were 63.1% and 63.1% for Black patients versus 89.1% and 83.0% for White patients (p=.0009). No significant differences by acuity or gender were found.</p><h3>Conclusions</h3><p>Among readmitted patients, Black patients and patients who had emergency surgery had less favorable CSE factors and poorer long-term survival. Earlier and more frequent follow-up in these patients should be considered. Developing off-campus clinics and specific post-discharge measures targeting these patients is important.</p>","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139664498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1016/j.jtcvs.2024.02.013
Igor Gosev, D. Pham, John Y. Um, A. Anyanwu, A. Itoh, K. Kotkar, Koji Takeda, Yoshifumi Naka, Matthias Peltz, Scott C. Silvestry, Gregory Couper, M. Leacche, Vivek Rao, Benjamin Sun, Ryan J. Tedford, N. Mokadam, Robert McNutt, Daniel Crandall, Mandeep R. Mehra, Christopher T. Salerno
{"title":"Ventricular Assist Device using a Thoracotomybased Implant Technique: Multi-center HeartMate 3 SWIFT Study","authors":"Igor Gosev, D. Pham, John Y. Um, A. Anyanwu, A. Itoh, K. Kotkar, Koji Takeda, Yoshifumi Naka, Matthias Peltz, Scott C. Silvestry, Gregory Couper, M. Leacche, Vivek Rao, Benjamin Sun, Ryan J. Tedford, N. Mokadam, Robert McNutt, Daniel Crandall, Mandeep R. Mehra, Christopher T. Salerno","doi":"10.1016/j.jtcvs.2024.02.013","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.02.013","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139830915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-06DOI: 10.1016/j.jtcvs.2023.12.023
Megan M. Chung, Cheryl Pan, Hideyuki Hayashi, Viswajit Kandula, Yanling Zhao, Dov Levine, Patra Childress, Lauren Sutherland, Syed T. Raza, Paul Kurlansky, Craig R. Smith, Hiroo Takayama
Objective
While postoperative atrial fibrillation (POAF) has been shown to be associated with worse survival after thoracic aortic surgery, its effect on outcomes independently from other postoperative complications is not well understood.
Methods
This is a single-center retrospective study of patients who underwent open thoracic aortic aneurysm repair between March 2005 and March 2021. POAF was defined as new-onset atrial fibrillation (AF) that developed during the index hospital stay. Patients with preoperative AF were excluded. Postoperative major complications included reoperation for bleeding, respiratory failure, acute renal failure, and stroke. Variables associated with POAF were analyzed with multivariable regression. Survival of patients without major complications was compared between patients without AF to patients with POAF after propensity score matching for baseline and intraoperative characteristics.
Results
Of 1,454 patients, 520 (35.8%) were observed to have POAF. Patients with POAF had a higher rate of postoperative major complications than those without AF (20.2% vs. 12.2%, p<0.001). Ten year survival was 82.0% in patients with POAF and 87.0% in patients without AF (p=0.008). In the cohort of patients without complications, 10-year survival was similar between patients with and without POAF after propensity score matching (83.6% vs. 83.8%, p=0.75).
Conclusions
POAF is common after open proximal thoracic aortic aneurysm repair. While development of major postoperative complications is associated with POAF and decreased long-term survival, isolated POAF does not appear to influence long-term survival.
{"title":"Significance of Isolated Postoperative Atrial Fibrillation in Thoracic Aortic Aneurysm Repair","authors":"Megan M. Chung, Cheryl Pan, Hideyuki Hayashi, Viswajit Kandula, Yanling Zhao, Dov Levine, Patra Childress, Lauren Sutherland, Syed T. Raza, Paul Kurlansky, Craig R. Smith, Hiroo Takayama","doi":"10.1016/j.jtcvs.2023.12.023","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2023.12.023","url":null,"abstract":"<h3>Objective</h3><p>While postoperative atrial fibrillation (POAF) has been shown to be associated with worse survival after thoracic aortic surgery, its effect on outcomes independently from other postoperative complications is not well understood.</p><h3>Methods</h3><p>This is a single-center retrospective study of patients who underwent open thoracic aortic aneurysm repair between March 2005 and March 2021. POAF was defined as new-onset atrial fibrillation (AF) that developed during the index hospital stay. Patients with preoperative AF were excluded. Postoperative major complications included reoperation for bleeding, respiratory failure, acute renal failure, and stroke. Variables associated with POAF were analyzed with multivariable regression. Survival of patients without major complications was compared between patients without AF to patients with POAF after propensity score matching for baseline and intraoperative characteristics.</p><h3>Results</h3><p>Of 1,454 patients, 520 (35.8%) were observed to have POAF. Patients with POAF had a higher rate of postoperative major complications than those without AF (20.2% vs. 12.2%, p<0.001). Ten year survival was 82.0% in patients with POAF and 87.0% in patients without AF (p=0.008). In the cohort of patients without complications, 10-year survival was similar between patients with and without POAF after propensity score matching (83.6% vs. 83.8%, p=0.75).</p><h3>Conclusions</h3><p>POAF is common after open proximal thoracic aortic aneurysm repair. While development of major postoperative complications is associated with POAF and decreased long-term survival, isolated POAF does not appear to influence long-term survival.</p>","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139375969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimized strategy to improve the outcomes of acute type A aortic dissection with malperfusion syndrome","authors":"Shuangkun Chen, Hua Peng, Zhuang Hui, Juxiang Wang, Pianpian Yan, Weiqun Zhang, Weiliang Zheng, Mingyu Li, Xijie Wu","doi":"10.1016/j.jtcvs.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.01.006","url":null,"abstract":"","PeriodicalId":501609,"journal":{"name":"The Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139456432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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