Annals of Thoracic Surgery

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BACKGROUND: Using a nationally representative database, the present study evaluated the degree of center-level variation in the cost of transcatheter aortic valve replacement (TAVR). METHODS: All adults undergoing elective, isolated TAVR were identified in the 2016-2018 Nationwide Readmissions Database. Multi-level, mixed effects models were used to identify patient and hospital characteristics associated with hospitalization costs. The random intercept for each hospital was generated and considered to be the baseline cost attributable to care at each center...

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BACKGROUND: Despite evidence demonstrating that lung cancer screening (LCS) decreases mortality, widespread implementation is lagging. Efforts to identify and recruit patients for LCS are in need. Candidacy for LCS is based on identifiable risk factors, many of which overlap with those of head and neck malignancies. Thus, we aimed to evaluate the prevalence of candidacy for LCS in the head and neck cancer patient population. METHODS: We performed a review of anonymous surveys collected from patients who presented to a head and neck cancer clinic...

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BACKGROUND: Postoperative pulmonary complications increase mortality following cardiac surgery. Conventional ultrafiltration may reduce pulmonary complications by removing mediators of bypass-induced inflammation and countering hemodilution. We tested the primary hypothesis that conventional ultrafiltration reduces postoperative pulmonary complications, and secondarily, improves early pulmonary function assessed by the ratio of arterial partial pressure to fractional inspired oxygen concentration...

BACKGROUND: Biventricular heart failure remains a clinically challenging condition to manage. Available literature describing durable biventricular (BiVAD) utilization has numerous limitations hindering the development of useful treatment algorithms. Analysis of BiVAD use within a large multicenter dataset is needed to clarify outcomes associated with this therapy. METHODS: The STS INTERMACS database was queried to identify adults≥18 years who received durable circulatory support from 1/1/10 - 12/31/20...

BACKGROUND: Air leaks is the major factor which influences the permanence of the chest tube and the in-hospital length of stay (LOS) among patients undergoing lung resections. The aim of this study is to determine if the use of digital chest systems, compared with traditional ones, reduces the duration of chest drainage and postoperative in-hospital LOS in patients undergoing video-assisted thoracoscopy (VATS) lobectomy. METHODS: The study is a prospective, randomized, multicenter trial...

BACKGROUND: Bipolar radiofrequency (RF) clamps are commonly used during surgical ablation for atrial fibrillation (AF). This study examined the efficacy of an irrigated bipolar RF clamp to create transmural lesions in an ex-vivo human heart model. METHODS: 10 donor hearts, turned down for transplantation, were explanted and arrested with cold cardioplegia. The ablations of the Cox Maze Procedure (CMP-IV) were performed using an irrigated bipolar RF clamp, CardioblateⓇLP (Medtronic, Inc)...

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BACKGROUND: The selective adenosine A2A receptor (A2AR) agonist Regadenoson reduces inflammation due to lung ischemia-reperfusion injury (IRI). The objective of this study was to investigate molecular and cellular mechanisms by which regadenoson reduces IRI in lung transplant recipients. METHODS: Fourteen human lung transplant recipients were infused for 12 hours with regadenoson and seven more served as untreated controls. Plasma levels of high mobility group box 1 and its soluble receptor for advanced glycation end-products (sRAGE) were measured by Luminex...

BACKGROUND: Surgical resection following neoadjuvant therapy remains the cornerstone of curative management of esophageal adenocarcinoma, and is frequently used for squamous cell carcinoma. The optimal extent of lymphadenectomy, and whether increasing lymph node yields confers a survival benefit remains unclear. Guidelines suggest resecting and examining a minimum of 15 lymph nodes at esophagectomy. This study assesses the impact of lymph node yield and lymph node ratio (LNR) on survival, identifying factors influencing nodal yield and radicality of resection...