Journal of Thoracic and Cardiovascular Surgery

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OBJECTIVE: Late HTN after CoA repair contributes to higher morbidity and mortality. An association between TAA hypoplasia and HTN has been found, but its relationship with surgical strategy is unclear. We studied the association between late HTN and initial surgical strategy pertaining to the TAA. METHODS: We retrospectively reviewed patients who underwent surgical repair of CoA during infancy with at least 10 years follow-up, excluding those with atypical coarctation, major associated heart defects, and residual isthmic narrowing...

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OBJECTIVES: Machine learning is evolving quickly in cardiovascular and thoracic surgery. Maximizing the capabilities of machine learning can help to improve patient risk stratification and clinical decision-making, improve accuracy of predictions, and help improve resource utilization in cardiac surgery. There are many nuances and intricacies in machine learning modeling which need to be understood to appropriately implement these technologies in the clinical research setting. Therefore, the goal of this primer is to provide an educational framework of machine learning for generating predicted probabilities in clinical research and to illustrate it with a real-world clinical example...

OBJECTIVE: Long-term outcomes after multi-valve cardiac surgery remain under-evaluated. METHODS: Medicare administrative claims from 2008-2019 identified beneficiaries undergoing multi-valve surgery. Operative characteristics were doubly-adjudicated using International Classification of Diseases and Current Procedural Technology codes. A multivariable flexible parametric model evaluated predictors of survival; regression standardization was performed to predict standardized survival probabilities (SSP) at varying percentiles of annual valvar volume...

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OBJECTIVE: There is a critical shortage of donor lungs for transplantation. We previously developed a parsimonious, highly discriminatory nine-variable Lung Donor (LUNDON) acceptability score. We assess the utility of this score as a tool to improve lung recovery rates for transplantation. METHODS: We examined all brain-dead donors between 2014-2020 from three US organ procurement organizations and validated the score's predictive performance. We examined the trajectory of donors with low (<40) and high (>60) initial LUNDON scores, their corresponding lung recovery rates, factors contributing to score improvement using multivariable regression models, and one-year post-transplant recipient survival...

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OBJECTIVE: (s): This study investigates outcomes of the reverse double switch operation (R-DSO) and ventricular switch (VS), novel approaches for patients with D-looped borderline left hearts that utilize the morphologic right ventricle as the systemic ventricle and the hypoplastic left ventricle as the sub-pulmonary ventricle. METHODS: This retrospective review analyzed early outcomes of children who underwent R-DSO/VS at a single institution between 2015 and 2023...

OBJECTIVES: The efficacy and safety of macitentan, an endothelin receptor antagonist, were assessed in Fontan-palliated patients over a 52-week, multicenter, randomized, placebo-controlled, double-blind trial (RUBATO-DB) and an open-label extension trial (RUBATO-OL). METHODS: Patients aged ≥12 years, New York Heart Association functional class II/III, underwent total cavopulmonary connection >1 year pre-screening and showed no signs of Fontan failure/clinical deterioration...

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No abstract text is available yet for this article.

OBJECTIVE: Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease occurring primarily in women. Pneumothorax and chylothorax are common pleural complications in LAM. We aim to explore various options in the surgical management of pleural disease in LAM. METHODS: A retrospective chart review of all patients at the Center for LAM and Rare Lung Diseases at Columbia University was performed, and date, type and indication for surgical procedure were collected. All patients with any cystic lung disease seen between January 1, 2000 and March 1, 2023 were included in the database...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: We sought to evaluate the interaction between smoking status and operative approach following esophagectomy on perioperative outcomes. METHODS: Patients undergoing esophagectomy for esophageal cancer were identified from the STS-GTSD Database between January 1, 2009 and December 31, 2022 and divided into six groups based on smoking status [never (NS), former (FS), current (CS)] and surgical approach [minimally invasive (MIE), open (OpenE)]. Primary outcomes were respiratory complications, operative mortality, major morbidity, and composite major morbidity and mortality...

OBJECTIVE: Endocardial fibroelastosis (EFE) is a major effector in the maldevelopment of the heart in patients with congenital heart disease. Despite successful surgical removal, EFE can redevelop, but the underlying cause of EFE recurrence remains unknown. HYPOTHESIS: This study aimed to identify hemodynamic predictors and genetic links to epithelial/endothelial-to-mesenchymal transition (EMT/EndMT) alterations for preoperative risk assessment. METHODS: We assessed the impact of preoperative hemodynamic parameters on EFE recurrence in a cohort of 92 patients with congenital heart disease who underwent left ventricular (LV) EFE resection between January 2010 and March 2021...

OBJECTIVE: To determine the durability of mitral valve repair with complete ring or flexible band annuloplasty in patients with atrial functional mitral regurgitation due to atrial fibrillation and identify risk factors associated with postoperative mitral regurgitation recurrence. METHODS: From 1/1/2000-1/1/2023, 194 adults with history of atrial fibrillation underwent mitral valve repair with annuloplasty alone for moderate/severe atrial functional mitral regurgitation...

OBJECTIVE: To develop and validate a scoring system to predict mid-term adverse events after elective thoracic endovascular aortic repair (TEVAR). METHODS: A multi-center, retrospective, and observational cohort study. A total of 350 patients who underwent elective TEVAR for thoracic aortic disease between January 2008 and December 2021 were analyzed. The primary outcome was the first adverse event occurring within 5 years of the initial TEVAR, which included death during the initial hospitalization, perioperative neurological complication, stent graft-induced new entry, dissection, rupture, graft infection, and reintervention related to the initial TEVAR...

OBJECTIVE: Reoperative aortic root replacement (ARR) is a technically challenging procedure. This study assesses the influence of reoperation on outcomes following ARR, particularly after prior acute type A aortic dissection (ATAAD) repair. METHODS: Of the 1823 patients in this study, 1592 (87.3%) underwent primary ARR, and 231 (12.7%) underwent reoperative ARR. Within the reoperative ARR group, 69 patients (29.9%) had previous ATAAD repair, and 162 patients (70...