Jewish Hospital

About: Jewish Hospital is a healthcare organization based out in Cincinnati, Ohio, United States. It is known for research contribution in the topics: Antigen & Population. The organization has 3881 authors who have published 3414 publications receiving 123044 citations.

Clinical and operative characteristics of patients randomized to coronary artery bypass surgery in the bypass angioplasty revascularization investigation (BARI)

Abstract: The surgical cohort of the Bypass Angioplasty Revascularization Investigation (BARI) is the largest group of patients with multivessel coronary artery disease randomly assigned to surgical treatment. This report presents baseline and operative characteristics of the cohort and describes some aspects of the variability in surgical practice among the 14 primary clinical centers and 4 co-investigational sites participating in BARI. Preoperative clinical and angiographic data and intraoperative variables were reviewed in 892 patients who were randomly assigned to coronary artery bypass grafting (CABG) and underwent operation. Associations between patient/lesion variables and operative characteristics are described. Of patients assigned to CABG, 87% underwent an operation within 2 weeks of randomization, as recommended in the protocol. Mean age of the 892 patients was 61 years, and mean age of the 235 women was greater than that of men (64 years vs 60 years); 64% of the surgical patients were classified as having unstable angina during the 6 weeks prior to randomization. Coronary angiography demonstrated 3-vessel disease (50% diameter narrowing by caliper measurement) in 41% of patients, and disease of the left anterior descending coronary artery was present in 87% of patients. A mean of 3.1 coronary arteries per patient were bypassed, and 82% of patients received 1 (70%) or 2 (12%) internal thoracic artery grafts. Prevalence of internal thoracic grafts was lower in elderly patients (74% of patients ≥ 70 years), in women (72% vs 85% in men; p

Partial Left Ventriculectomy: The 2nd International Registry Report 2000

Abstract: Background: Partial left ventriculectomy (PLV) has been performed without standardized inclusion or exclusion criteria. Methods: An international registry of PLV was expanded, updated, and refined to include 287 nonischemic cases voluntarily reported from 48 hospitals in 11 countries. Results: Gender, age, ventricular dimension, etiology, ethnology, myocardial mass, operative variation, presence or absence of mitral regurgitation, and transplant indication had no effects on event-free survival, which was defined as absence of death or ventricular failure that required a ventricular assist device or listing for transplantation. Preoperative patient conditions, such as duration of symptoms (> 9 vs 12%; p = 0.001), and refractory decompensation that required emergency procedure (p < 0.001) were associated with reduced event-free survival. Five or more cases in each hospital led to significantly better outcomes then the initial four cases. Rescue procedures for 14 patients nonsignificantly improved patient survival (2-year survival 52%) over event-free survival (2-year survival 48%; p = 0.49), with improved NYHA class among survivors (3.6 to 1.8; p < 0.001). Outcome was better in 1999 then in all series before 1999 (p = 0.02) most likely due to patient selection, which was refined to avoid known risk factors such as reduced proportion of patients in NYHA Class IV, FS < 5%, and hospitals with experience in 10 or less cases. A combination of these risk factors could have stratified 17 high-risk patients with 0% 1-year survival and 26 low-risk patients with 75% 2-year event-free survival. Conclusion: Avoidance of risk factors appears to improve survival and might help stratify high- or low-risk patients. Although less symptomatic patients with preserved contractility had better results after PLV, change of indication requires prospective randomized comparison with medical therapies or other approaches.