JTCVS open最新文献

{"title":"Incomplete ablation as a mechanism of atrial fibrillation recurrence and atrial tachycardia development after maze procedure","authors":"Takashi Nitta MD, PhD ,&nbsp;Yuki Iwasaki MD, PhD ,&nbsp;Shun-ichiro Sakamoto MD, PhD ,&nbsp;Masahiro Fujii MD, PhD ,&nbsp;Toshiaki Otsuka MD, PhD ,&nbsp;Yosuke Ishii MD, PhD","doi":"10.1016/j.xjon.2024.10.031","DOIUrl":"10.1016/j.xjon.2024.10.031","url":null,"abstract":"<div><h3>Objective</h3><div>Atrial tachyarrhythmias are the most frequent complication after the maze procedure. We examined the mechanism of atrial tachyarrhythmias in association with the ablation energy and technique used at each lesion and by the findings of postoperative electrophysiological study.</div></div><div><h3>Methods</h3><div>Four-hundred fifty-three patients who underwent the maze procedure with biatrial incisions and bilateral pulmonary vein (PV) isolation were examined for the incidence and mechanism of recurrence of atrial fibrillation (AF) and development of atrial tachycardia (AT). PV isolation was performed by radiofrequency (RF) ablation, cryothermia, or cut-and-sew technique. The atrioventricular isthmi and the coronary sinus (CS) were ablated by RF, cryothermia, or a combination of these.</div></div><div><h3>Results</h3><div>Of 443 patients who survived surgery (98%), 54 patients (12.2%) had recurrent AF and 36 patients (8.1%) developed AT during the median of 28 months (interquartile range, 3-75) postoperatively. Multivariate logistic regression analysis showed preoperative left atrial dimension and nonperformance of intraoperative PV pacing were the independent predictors for AF recurrence. Electrophysiologic study in patients with AT demonstrated incomplete ablation in 24 patients (67%), most frequently at the CS in 16 patients (67%), and non-PV focal activations in 16 patients (44%). Preoperative New York Heart Association functional class of 1 and nonperformance of additional epicardial ablation of the CS were the independent predictors for postoperative AT development.</div></div><div><h3>Conclusions</h3><div>Incomplete ablation is a cause of AF recurrence and AT development after the maze procedure. Intraoperative PV pacing prevents AF recurrence and additional epicardial CS ablation prevents AT development.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 110-119"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: A history of cardiothoracic surgery in Africa","authors":"Beshoy Allam MSc,&nbsp;Mahmoud Alhussaini MD,&nbsp;Moustafa Loay MB, BCH,&nbsp;Mostafa Kotb MB, BCH,&nbsp;Hussein Elkhayat MD","doi":"10.1016/j.xjon.2024.11.016","DOIUrl":"10.1016/j.xjon.2024.11.016","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Page 386"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentator Discussion: Routine use of jejunostomy tubes after esophagectomy: The good, the bad, and the ugly!","authors":"","doi":"10.1016/j.xjon.2024.10.021","DOIUrl":"10.1016/j.xjon.2024.10.021","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 288-289"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of bupivacaine liposomal injectable suspension in children aged 2 to 6 years undergoing cardiac surgery does not accelerate recovery","authors":"Lindsay J. Nitsche BS ,&nbsp;Paul J. Devlin MD, MSc ,&nbsp;Sarah J. Bond MS, PA-C ,&nbsp;Jeremy A. Friedman MD ,&nbsp;Kaitlyn R. Rubnitz PA-C ,&nbsp;Emily Schwartz MSN, CRNP ,&nbsp;Colleen E. Bontrager BA ,&nbsp;Lauren I. Karel PharmD ,&nbsp;Susan C. Nicolson MD ,&nbsp;Stephanie M. Fuller MD, MS","doi":"10.1016/j.xjon.2024.11.013","DOIUrl":"10.1016/j.xjon.2024.11.013","url":null,"abstract":"<div><h3>Objective</h3><div>Bupivacaine liposomal injectable suspension is proven safe and effective for selective postsurgical analgesia in children older than 6 years. We evaluated if intraoperative bupivacaine liposomal injectable suspension administration decreases postoperative opioid use, peak pain scores, and length of stay in children aged 2 to 6 years undergoing cardiac surgery via median sternotomy.</div></div><div><h3>Methods</h3><div>Serial patients aged 2 to 6 years undergoing cardiac surgery received 4 mg/kg bupivacaine liposomal injectable suspension mixed with 0.25% bupivacaine hydrochloride and 0.9% sodium chloride via local infiltration at the conclusion of their procedure. They were matched with controls who underwent operation within the past 5 years by procedure, age, gender, and weight. Postoperative opioid use was converted into morphine milligram equivalents, and pain severity was measured using the Face, Legs, Activity, Cry, and Consolability scale. Paired <em>t</em> tests, chi-square tests, and descriptive statistics were used depending on the nature of the data.</div></div><div><h3>Results</h3><div>A total of 100 patients receiving bupivacaine liposomal injectable suspension and matching historical control patients aged 2 to 6 years were analyzed. There were no significant differences in preoperative variables. Patients receiving bupivacaine liposomal injectable suspension received an average of 3.6 (95% CI, 1.2-6.0) fewer morphine milligram equivalents (<em>P</em> = .003). However, there was no significant difference in peak pain score (<em>P</em> = .4), time to first enteral intake (<em>P</em> = .5), intensive care unit length of stay (<em>P</em> = 1), or hospital length of stay (<em>P</em> = .2). The median cost of bupivacaine liposomal injectable suspension was higher than that of bupivacaine hydrochloride (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Intraoperative bupivacaine liposomal injectable suspension use in children aged 2 to 6 years undergoing cardiac surgery showed statistically but not clinically significant decreases in postoperative opioid use. Bupivacaine liposomal injectable suspension use had no impact on intensive care unit or hospital length of stay but was substantially more expensive.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 245-255"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of the femoral pulse and mesenteric perfusion pressure in acute aortic dissection","authors":"Benjamin M. Pinsky BS ,&nbsp;Minhaj S. Khaja MD, MBA ,&nbsp;Bo Yang MD, PhD ,&nbsp;Himanshu J. Patel MD ,&nbsp;Karen M. Kim MD ,&nbsp;Shinichi Fukuhara MD ,&nbsp;G. Michael Deeb MD ,&nbsp;Nicholas Burris MD ,&nbsp;Amber Liles MD, MPH ,&nbsp;William Sherk MD ,&nbsp;David M. Williams MD","doi":"10.1016/j.xjon.2024.10.028","DOIUrl":"10.1016/j.xjon.2024.10.028","url":null,"abstract":"<div><h3>Background</h3><div>Visceral malperfusion is a serious complication of acute aortic dissection. Currently, diagnosis relies on signs of end-organ failure, which may be clinically obscure and delay crucial treatment.</div></div><div><h3>Objective</h3><div>The aim was to investigate external iliac (IA) and superior mesenteric artery (SMA) pressures in cases where both vessels originate exclusively from the true lumen to develop and validate a novel early indicator of visceral malperfusion.</div></div><div><h3>Methods</h3><div>Endovascular pressure measurements from 488 patients with acute aortic dissection were analyzed. Exclusion criteria included static obstruction of the branch vessel or substantial re-entry tear below the SMA origin.</div></div><div><h3>Results</h3><div>In acute type A aortic dissection, 69 out of 244 (28.3%) patients had at least 1 common IA and the SMA with exclusive true lumen perfusion. Among all patients with acute type A aortic dissection, 41 (16.8%) patients with 49 external IA pressure measurements met inclusion criteria. Pressures in right external IA (n = 27) and left external IA (n = 22) correlated significantly with SMA perfusion pressure (<em>r</em>² = 0.86 [95% CI, 0.71-0.93; <em>P</em> = 1.03^E-08] and <em>r</em>² = 0.86 [95% CI, 0.69-0.94; <em>P</em> = 2.85^E-07], respectively).</div><div>In settings of acute type B aortic dissection, 81 out of 244 (33.2%) patients had at least 1 common IA and the SMA with exclusive true lumen perfusion. Among all patients with acute type B aortic dissection, 35 (14.3%) patients with 44 external IA pressure measurements met inclusion criteria. The right external IA (n = 24) and left external IA (n = 20) pressures correlated significantly with SMA perfusion pressure (<em>r</em>² = 0.92 [95% CI, 0.83-0.97; <em>P</em> = 1.^59E-10] and <em>r</em>² = 0.87 [95% CI, 0.70-0.95; <em>P</em> = 6.12^E-07], respectively).</div></div><div><h3>Conclusions</h3><div>In acute aortic dissection where the SMA and a common IA are supplied exclusively by the true lumen, external IA systolic pressures correlate significantly with SMA systolic pressures. In this group, therefore, clinical loss of the femoral pulse likely indicates significantly decreased SMA pressures, raising concern for visceral malperfusion, possibly before visceral enzymes can respond. We believe that computed tomography reports should highlight this anatomical finding to alert the clinical team monitoring the patient.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 34-43"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of the German Registry for Acute Aortic Dissection Type A score in patients undergoing surgery for acute type A aortic dissection","authors":"Danial Ahmad MD, MPH ,&nbsp;Derek Serna-Gallegos MD, FACS ,&nbsp;Ariana Jackson BS ,&nbsp;David J. Kaczorowski MD ,&nbsp;Johannes Bonatti MD ,&nbsp;David M. West MD ,&nbsp;Pyongsoo D. Yoon MD ,&nbsp;Danny Chu MD ,&nbsp;Joe Squire MSN, RN ,&nbsp;Floyd Thoma BS ,&nbsp;Jianhui Zhu PhD ,&nbsp;Julie Phillippi PhD ,&nbsp;Ibrahim Sultan MD","doi":"10.1016/j.xjon.2024.12.007","DOIUrl":"10.1016/j.xjon.2024.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>Surgery for acute type A aortic dissection carries a high risk of morbidity and mortality compared with routine cardiac surgical procedures. The German Registry for Acute Aortic Dissection Type A score has been recommended for use as a mortality risk-stratification tool in recent guidelines. We sought to externally validate this score in our local population.</div></div><div><h3>Methods</h3><div>All consecutive patients undergoing surgery for acute type A aortic dissection from 2007 to 2021 were included. Logistic regression analyses were performed. Model discrimination was assessed by C-statistic with 95% CIs as part of the receiver operating characteristic analysis. Model performance was visualized by calibration plot and quantified by the Brier score.</div></div><div><h3>Results</h3><div>A total of 587 patients were included. The mean age was 61 years (±13.5), with 42.08% of patients aged more than 65 years; 40.37% were female. The mean circulatory arrest time was 30.9 minutes (±16.5). Hemiarch replacement was performed in 62% of patients, and total arch replacement was performed in 35.3% of patients. Thirty-day mortality was observed in 66 patients (11.24%), and stroke was present in 7.16% of patients. The C-statistic revealed good discriminatory ability for predicting 30-day mortality (area under the receiver operating characteristic curve, 0.73; 95% CI, 0.67-0.79; <em>P</em> &lt; .0001). Model calibration was good (Brier score = 0.094).</div></div><div><h3>Conclusions</h3><div>The German Registry for Acute Aortic Dissection Type A score for 30-day mortality showed good discriminatory ability in our local population along with good ability for prediction of mortality, indicating its potential clinical utility in the population with acute type A aortic dissection.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 81-88"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of surgical valve replacements for radiation-induced valvulopathy","authors":"Annie R. Abruzzo BA ,&nbsp;Siobhan McGurk BS ,&nbsp;George Tolis Jr MD ,&nbsp;Sary Aranki MD ,&nbsp;Ashraf Sabe MD ,&nbsp;Mark J. Cunningham MD ,&nbsp;Anju Nohria MD ,&nbsp;Akinobu Itoh MD, PhD","doi":"10.1016/j.xjon.2024.10.024","DOIUrl":"10.1016/j.xjon.2024.10.024","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with cancer who receive radiation therapy to the thorax often develop radiation-induced heart disease (RIHD) decades later. Previous chest radiation is associated with elevated perioperative risk of complications and mortality after cardiac surgery. Whether the type of valve (mechanical vs bioprosthetic) used affects outcomes in patients with RIHD is unknown.</div></div><div><h3>Methods</h3><div>This retrospective review analyzed the characteristics and postoperative outcomes of patients with a previous history of chest radiation for Hodgkin or non-Hodgkin lymphoma who underwent surgical valve replacement at a single institution between 2000 and 2021. Both 30-day perioperative outcomes and long-term survival were assessed.</div></div><div><h3>Results</h3><div>Patients who received mechanical valve tended to be younger, have more valves replaced, and have undergone previous coronary artery bypass grafting than bioprosthetic valve recipients. Valve type alone did not alter perioperative complications or overall survival. Median survival was 11.0 years in mechanical and 10.9 years in bioprosthetic valve patients (<em>P</em> = .930). Twelve patients underwent valve reinterventions (6 mechanical, 6 bioprosthetic), and 3 underwent transplant. Single-valve (aortic valve or mitral valve) recipients fared better with median survival of 13.3 years compared with 6.2 years in those who underwent combined aortic valve replacement plus mitral valve replacement (<em>P</em> &lt; .0001).</div></div><div><h3>Conclusions</h3><div>Patients with RIHD who undergo surgical valve replacement have similarly suboptimal short- and long-term outcomes regardless of mechanical versus bioprosthetic valve type. Those who required combined aortic and mitral valve replacement had especially high 10-year overall mortality. Further investigation in a larger dataset including transcatheter approaches is warranted.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 134-146"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation therapy does not improve survival in patients who are upstaged after esophagectomy for clinical early-stage esophageal adenocarcinoma","authors":"Devanish N. Kamtam MBBS, MS ,&nbsp;Nicole Lin MD ,&nbsp;Douglas Z. Liou MD ,&nbsp;Natalie S. Lui MD ,&nbsp;Leah M. Backhus MD ,&nbsp;Joseph B. Shrager MD ,&nbsp;Mark F. Berry MD","doi":"10.1016/j.xjon.2024.11.001","DOIUrl":"10.1016/j.xjon.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>Radiation after esophagectomy may cause conduit dysfunction with unclear oncologic benefits. We hypothesized that adjuvant chemoradiation does not improve survival over chemotherapy alone for patients with pathologic upstaging after primary surgery for cT1-2N0M0 esophageal adenocarcinoma.</div></div><div><h3>Methods</h3><div>The impact of adjuvant therapy after primary surgery for cT1-2N0M0 esophageal adenocarcinoma upstaged to pT3-4 or pN+ in the National Cancer Database (2004-2019) was evaluated with logistic regression, Kaplan–Meier analysis, and Cox modeling.</div></div><div><h3>Results</h3><div>A total of 574 patients met inclusion criteria, 300 (52.3%) who received adjuvant therapy (chemotherapy alone in 117 [39.0%], radiation alone in 15 [5.0%], chemoradiation in 168 [56.0%]) and 274 (47.7%) who did not. Adjuvant therapy was associated with improved 5-year survival (46.8% vs 32.7%, <em>P</em> &lt; .001). In multivariate analysis controlling for age, year of diagnosis, Charlson Comorbidity Index, pT, pN, and positive margins, adjuvant chemotherapy was independently associated with improved survival (hazard ratio, 0.62, 95% CI, 0.46-0.84, <em>P</em> = .002); radiation use did not have a statistically significant association with survival (hazard ratio, 1.19, 95% CI, 0.86-1.63, <em>P</em> = .29). Among patients who received chemotherapy, independent predictors of also receiving radiotherapy included pathological T-upstaging (odds ratio, 2.01, 95% CI, 1.04-3.88, <em>P</em> = .037) and distance from facility less than 50 miles (odds ratio, 2.13, 95% CI, 1.05-4.33, <em>P</em> = .037). In univariate analysis of patients who received adjuvant therapy, chemotherapy alone was associated with significantly better 5-year survival compared with chemoradiation (54.2% vs 41.6%, <em>P</em> = .004). Landmark analyses at 3 and 6 months were consistent with the primary analysis.</div></div><div><h3>Conclusions</h3><div>Using radiation with chemotherapy as adjuvant therapy for patients upstaged after esophagectomy for cT1-2N0 esophageal adenocarcinoma is not associated with improved survival and should be considered only in select situations based on careful clinical evaluation.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 290-308"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentator Discussion: Potential advantage of magnetic resonance imaging in detecting thoracic wall infiltration in pleural mesothelioma. A retrospective single-center analysis","authors":"","doi":"10.1016/j.xjon.2024.10.022","DOIUrl":"10.1016/j.xjon.2024.10.022","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 326-327"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of heparin-induced thrombocytopenia after cardiac surgery","authors":"Emily Rodriguez BS ,&nbsp;Maria Daskam BS ,&nbsp;Benjamin L. Shou MD ,&nbsp;Charles Woodrum MS ,&nbsp;Ria Gupta BS ,&nbsp;Kathryn E. Dane PharmD ,&nbsp;Diane Alejo BA ,&nbsp;Marc Sussman MD ,&nbsp;Stefano Schena MD, PhD","doi":"10.1016/j.xjon.2024.10.029","DOIUrl":"10.1016/j.xjon.2024.10.029","url":null,"abstract":"<div><h3>Objective</h3><div>Heparin-induced thrombocytopenia (HIT) after cardiac surgery may lead to greater morbidity and mortality than predicted preoperatively. The aim of this study is to assess long-term outcomes of patients surviving HIT after cardiac surgery.</div></div><div><h3>Methods</h3><div>Single-institution, retrospective study of adult patients who underwent cardiac surgery between 2011 and 2023 and developed HIT postoperatively. The institutional Society of Thoracic Surgeons database and electronic medical record were integrated with longitudinal data from phone questionnaires. HIT was defined by combined clinical (4Ts score) and serologic manifestations: a platelet decrease &gt;50% from preoperative baseline, a high optical density positive heparin-PF4 antibody test, and a positive serotonin release assay.</div></div><div><h3>Results</h3><div>We identified 88 of 11,658 patients (0.8%) with HIT after cardiac surgery. The majority were male (74%), white (73.8%), and with a mean age of 65.6 ± 11.6 years. Seventy-seven (87.5%) survived to discharge, had a 4Ts score of 5 [4-6], and 58 (75.3%) were discharged on oral anticoagulation, with only 22 (28.6%) receiving treatment for the past 3 months, for a median of 1.3 [0.8-4.5] years. Median length of stay was 24 [17-35] days and length of follow-up was 4.6 [0.3-12] years. Readmission occurred in 70.1% (n = 54) of patients, with an average of 3 [1-6] readmissions/patient. Causes of death during follow-up included cardiac (n = 7, 24.1%), infectious (n = 6, 20.7%), or neurologic events (n = 5, 17.3). Ten-year survival probability was 48%.</div></div><div><h3>Conclusions</h3><div>Patients who develop HIT after cardiac surgery have an overall poor prognosis even after hospital discharge. In addition to prolonged hospitalization, patients experience further complications leading to frequent early readmissions and elevated mortality in the long-term.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"23 ","pages":"Pages 190-198"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}