Annals of Thoracic Surgery

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The 14th Annual Report from The Society of Thoracic Surgeons (STS) Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) describes outcomes of 27,493 patients with a continuous-flow left ventricular assist device (LVAD) from the past decade (2013-2022). In 2022, 2517 primary LVADs were implanted, of which 2512 (99.8%) were fully magnetically levitated (Mag-Lev) devices. This shift to nearly exclusive use of a Mag-Lev device led us to examine its outcomes compared with contemporary (2018-2022) and historical (2013-2017) non-Mag-Lev cohorts...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

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BACKGROUND: Our Thoracic Enhanced Recovery Program (ERP) decreased the use of postoperative morphine equivalents and hospital costs one year after implementation at our tertiary center. The sustainability and potential increasing benefit of this program were evaluated. METHODS: From 2015 to 2021, we prospectively analyzed the outcomes of patients who underwent elective pleural, pulmonary, or mediastinal surgery at our institution. Patients were separated based on the incision (video-assisted (VATS) or thoracotomy (T))...

BACKGROUND: Children undergoing cardiac surgery may require postoperative surgical or catheter-based reintervention prior to discharge. We examined racial/ethnic variations in reintervention and associated in-hospital mortality. METHODS: Children undergoing cardiac surgery from 2004 to 2015 were identified in the Pediatric Health Information Systems (PHIS) database. Regression analysis measured associations between race/ethnicity, in-hospital mortality, and postoperative cardiac surgical or catheter-based reintervention (Surgery/Catheter Reintervention)...

BACKGROUND: The impact of acute aortic dissection of the chronically dissected distal aorta is unknown. This study sought to describe the incidence and characteristics of the triple lumen aortic dissection and its impact on survival. METHODS: From 2010-2021, a query of a single institution aortic database identified 1149 patients with chronic distal aortic dissection. Thirty-three (2.9%) patients with at least three distinct lumens and two separate "primary" intimal tears were identified based upon analysis of contrast cross-sectional imaging...

More than half of symptomatic patients with hypertrophic cardiomyopathy (HCM) have left ventricular outflow tract (LVOT) obstruction. Septal reduction therapy by septal myectomy can dramatically relieve exertional dyspnea, chest pain, and presyncope in properly selected patients and is an important management pathway for many patients. The distribution and degree of hypertrophy in patients with obstructive hypertrophic cardiomyopathy (oHCM) are variable and, as discussed in this review, can influence clinical manifestations of the disease and surgical management...

BACKGROUND: Patients' race and/or ethnicity are increasingly being associated with differential surgical access and outcomes in cardiac surgery. However, poor diversity in study populations and conflicting research methodology and findings have made it difficult to derive evidence-based conclusions that can inform surgical care. Using a fictional patient example, this review identifies areas of concern in research engagement, methodology, and analyses as well as potential steps to improve race and ethnicity considerations in cardiac surgical research...

Outcomes for patients with esophageal cancer have improved over the last decade with the implementation of multimodality therapy. There are currently no comprehensive guidelines addressing multidisciplinary management of esophageal cancer that have incorporated the input of surgeons, radiation oncologists, and medical oncologists. To address the need for multidisciplinary input in the management of esophageal cancer and to meet current best practices for clinical practice guidelines, the current guidelines were created as a collaboration between The Society of Thoracic Surgeons (STS), American Society for Radiation Oncology (ASTRO), and the American Society of Clinical Oncology (ASCO)...

BACKGROUND: Many obstacles challenge the establishment and expansion of cardiac surgery in low- and middle-income countries, despite the unmet cardiac surgical needs. One challenge has been providing adequate follow-up care to monitor anticoagulation, manage morbidity, and prevent mortality. Here, we provide a systematic review of outcomes after valvular cardiac surgery, focusing on strategies for prolonged follow-up care in resource-constrained settings. METHODS: Studies published between 2012 and 2022 were collected from Embase and the Cochrane Library...

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BACKGROUND: Venous thromboembolism (VTE) is a potentially preventable serious complication in lung cancer patients undergoing thoracic surgery. We examined the risk and timing of VTE following surgery for primary non-small cell lung cancer (NSCLC). METHODS: in the Danish Lung Cancer Registry. VTE events in the year after surgery were assessed by stage, patient characteristics, and surgical procedure. RESULTS: We identified 13,197 patients who underwent surgery for NSCLC in 2003-2021 (mean age 67...

PURPOSE: A new automated ePTFE (expanded polytetrafluoroethylene) suture placement device and a new customized titanium fastener deployment device were clinically evaluated in open and less invasive mitral valve repair (MVr). DESCRIPTION: Twelve patients were followed for one year after undergoing MVr utilizing the study devices. The study endpoints included surgical outcomes, operative times, valve repair durability, adverse events, and mortality. EVALUATION: Three patients received 1 ePTFE chord using the study technology; nine patients received 2 chords...

BACKGROUND: The long-term effectiveness of minithoracotomy over redo median sternotomy for reoperative mitral operation is not well described. Here we present long-term survival after reoperative mitral operation based on operative approach. METHODS: Adults undergoing mitral valve operation with previous sternotomy by redo sternotomy and minithoracotomy were reviewed from our prospectively maintained institutional database from 1997 to 2022. Propensity score matching was performed to compare short- and long-term outcomes...