Showing papers in "The Annals of Thoracic Surgery in 2018"

TL;DR: This is the latest in a series of annual reports that outlines current national aggregate outcomes and volume trends in cardiac surgery and summarizes database-related work in quality measurement and performance improvement during the past year.

TL;DR: New STS ACSD risk models have generally excellent calibration and discrimination and are well suited for risk adjustment of STS performance metrics.

TL;DR: Calibration was excellent except for the deep sternal wound infection/mediastinitis model, which slightly underestimated risk because of higher rates of this endpoint in the more recent validation data; this will be recorded in each feedback report.

TL;DR: Although contemporary outcomes are excellent, earlier guideline-directed referral and increased frequency and quality of repair may further improve results of mitral valve operations.

TL;DR: Outcomes after implementation of ERAS in patients undergoing resection for pulmonary malignancy were evaluated and ERAS was associated with improved postoperative outcomes, including decreased length of stay and pulmonary and cardiac morbidity after thoracotomy but not after minimally invasive operations.

TL;DR: Any degree of PPM significantly decreased long-term survival and increased readmission rates for both heart failure and reoperation for AVR, and temporal trends show a significant decrease in the incidence over the past decade.

TL;DR: Implementation of thoracic ERAS is a dynamic process with potential to improve outcomes in thorACic surgical procedures and in the first year shortened length of stay, decreased opioid usage, minimized fluid overload, and decreased hospital costs.

TL;DR: MABG in the United States is associated with OM comparable to SABG and increased DSWI risk with BITA-MABG and should not in any way dissuade the use of MABG, given its well-established long-term survival advantage.

TL;DR: Although the OS rate was better for lobectomy than for wedge resection, no statistical differences in the LCSS rate were identified among the three treatment groups of patients with tumors that were 1.0 cm or smaller.

TL;DR: The learning phase of thoracic laparoscopic robot-assisted minimally invasive esophagectomy RAMIE consisted of 70 procedures in 55 months and a structured proctoring for RAMIE substantially reduced the number of procedures and time required to achieve proficiency.

TL;DR: Mortality and major morbidity after isolated tricuspid valve surgery can be predicted using preoperative patient data from The Society of Thoracic Surgeons National Adult Cardiac Database and an easily calculable clinical risk score is established.

TL;DR: In patients with previously metastatic or unresectable cancer, lung resection for suspected residual disease after immunotherapy is feasible, with high rates of R0 resection.

TL;DR: The scheme to categorize a ventricular septal defect uses both its location and the structures along its borders, thereby bridging the two most popular and disparate classification approaches and providing a common language for describing each phenotype.

TL;DR: This guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation therapy for CPB using the available evidence and will serve as a resource and will stimulate investigators to conduct more research and to expand on the evidence base.

TL;DR: In an enhanced national dataset representative of outcomes for stage IA NSCLC, sublobar resection was associated with a 39% increased risk of cancer recurrence.

TL;DR: When surgical outcomes are limited to surgeons who perform 20 or more annual procedures, the robotic-assisted approach is associated with a lower conversion-to-open rate and lower 30-day complication rate when than video-assisted thoracoscopic surgeons, with a mean operative time difference of 25 minutes.

TL;DR: Intention-to-treat analysis shows surgical duct ligation is more effective than thoracic duct embolization, with the ability to cannulate the cisterna chyli being the limiting factor.

TL;DR: Spread through air spaces was associated with clinicopathologically invasive features and was predictive of worse survival and positivity for STAS remained an independent prognostic factor for both recurrence-free survival and overall survival.

TL;DR: Higher readmission and reintervention rates were observed in patients managed with chest tubes, suggesting some of these patients may benefit from earlier definitive surgical intervention.

TL;DR: A reduced RFR appears to be a novel risk factor for AKI, and measurement of RFR preoperatively can identify patients who are likely to benefit from preventive measures or to select for use of biomarkers for early detection.

TL;DR: Sustained reduction in tricuspid regurgitation and favorable changes in the right ventricle at follow-up suggest that cone repair has an advantageous impact on right ventricular remodeling.

TL;DR: Aortic valve procedures increased significantly during this study period primarily due to the increase in TAVR, with clinical outcomes improving as well, and long-term outcomes of T AVR are still under investigation, which are promising.

TL;DR: This phase I trial provides preliminary evidence suggesting that folate receptor-targeted molecular imaging with OTL38 is safe, with tolerable grade I toxicity, and data suggest that OTL 38 accumulates in known lung cancers and may improve identification of synchronous malignancies.

TL;DR: Improved reach within the lung periphery may address some limitations with contemporary bronchoscopic approaches for peripheral lesion biopsy.

TL;DR: Psoas index is an easily obtained and reproducible measure of frailty that predicts risk-adjusted resource utilization, morbidity, and long-term mortality and may improve procedural selection and risk adjustment in high-risk patients with aortic valve disease.

TL;DR: Careful patient selection and early use of ECMO seems to allow for preservation of vitality while these critically ill candidates await donor organs, which may improve outcomes.

TL;DR: Current aggregate national outcomes in congenital and pediatric cardiac surgery is summarized and related activities in the areas of quality measurement, performance improvement, and transparency are reviewed.

TL;DR: Minimally invasive approaches to AVR yield excellent outcomes in high-volume centers and therefore should be considered in patients undergoing AVR, according to surgeon's technical expertise.

TL;DR: STAS is a prognostic factor of poor outcomes for sublobar resection in patients with lung cancer, and the worse prognosis for sub lobar resections would be associated with STAS.

TL;DR: The need for PPM after aortic valve replacement independently reduces long-term survival and the rate of PPM placement after surgical aortIC valve replacement remains very low but dramatically increases resource utilization.