Annals of Thoracic Surgery

BACKGROUND: Females with mitral valve disease have higher rates of tricuspid regurgitation(TR) than males. While tricuspid valve repair(TVr) decreases progression of TR, we hypothesize that there may be sex-based differences in concomitant TVr at the time of mitral surgery. METHODS: Adults undergoing mitral surgery for degenerative disease with moderate or worse preoperative TR at a high-volume center from 2014-2023 were identified. Patients with previous tricuspid intervention were excluded...

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BACKGROUND: Reports of cardiac operations after transcatheter aortic valve replacement (TAVR) and early TAVR explantation are increasing. The purpose of this report is to document trends and outcomes of cardiac surgery following initial TAVR. METHODS: The Society of Thoracic Surgeons Adult Cardiac Surgery Database was queried for all adult patients undergoing cardiac surgery after a previously placed TAVR between January 2012 and March 2023. This identified an overall cohort, as well as two subcohorts: non aortic valve surgeries, and surgical aortic valve replacement (SAVR) after previous TAVR...

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BACKGROUND: Chatbot use in medicine is growing, and concerns have been raised regarding their accuracy. We assessed the performance of four different chatbots in managing thoracic surgical clinical scenarios. METHODS: Topic domains were identified and clinical scenarios were developed within each domain. Each scenario included three stems utilizing Key Feature methods related to diagnosis, evaluation, and treatment. Twelve scenarios were presented to ChatGPT-4, Bard, Perplexity, and Claude 2 in three separate runs...

BACKGROUND: Societal guidelines support atrial fibrillation (AF) treatment during surgical aortic valve replacement (SAVR). Recently, many low-intermediate risk patients with AF are managed by transcatheter aortic valve replacement (TAVR). Therefore, we evaluated longitudinal outcomes in these populations. METHODS: The United States Centers for Medicare and Medicaid Services inpatient claims database was evaluated for all beneficiaries with AF undergoing TAVR or SAVR with/without AF treatment (2018-20)...

The Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (CHSD) continues to be the most comprehensive database of congenital and pediatric cardiothoracic surgical procedures in the world and contains information on 664,210 operations as of June 30, 2023. The thirty-fifth harvest of the STS CHSD data was undertaken in Spring 2023 spanning the 4-year period January 1, 2019, through December 31, 2022, and included 144,919 operations performed at 114 participating sites in North America. The harvest analysis was successfully executed by the STS research and analysis center...

BACKGROUND: There is a recognized lack of diversity among patients enrolled in cardiovascular interventional and surgical trials. Diverse patient representation in clinical trials is necessary to enhance generalizability of findings, which may lead to better outcomes across broader populations. The Cardiothoracic Surgical Trials Network (CTSN) recently developed a plan-of-action to increase diversity among participating investigators and trial participants -- the focus of this paper. METHODS: Review of literature and enrollment data from CTSN trials...

BACKGROUND: Mitral leaflet elongation is common in hypertrophic cardiomyopathy (HCM), contributes to obstructive physiology, and presents a challenge to dual surgical goals of abolition of outflow gradients and mitral regurgitation. Anterior leaflet shortening, performed as an ancillary surgical procedure during myectomy, is controversial. METHODS: This was a retrospective study of all patients undergoing myectomy from 1/2010 to 3/2020 analyzing survival and echocardiographic results...

BACKGROUND: The study purpose was to determine the optimal extent of lymph node dissection required in patients with small (≤ 3 cm) radiologically ground-glass opacity-dominant, peripheral, non-small cell lung cancer tumors. METHODS: We analyzed the clinicopathological findings/surgical outcomes of 988 patients with radiological, ground glass opacity-dominant non-small cell lung cancer without lymph node involvement who underwent complete resection of the primary tumor between 2010 and 2020...

BACKGROUND: Morbidity and mortality following the Norwood procedure remains high. Shunt size selection is not standardized and the impact of shunt size on outcomes is poorly understood. The Single Ventricle Reconstruction trial randomized infants to modified Blalock-Taussig-Thomas shunt (MBTTS) or right ventricle-to-pulmonary artery shunt (RVPAS) at the Norwood procedure. We assessed shunt size distribution and its association with postoperative outcomes. METHODS: We included 544 patients, excluding 5 with ambiguous shunt crossover data...

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