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Journal and News Scan
According to a presentation at the 103rd AATS Annual Meeting, Black cardiothoracic surgeons earn just 76–85 percent of the mean salary earned by white cardiothoracic surgeons. This number accompanies low diversity among the workforce. Presenters concluded that future studies are needed to understand the mechanisms of salary disparity and how to develop a more diverse workforce.
The authors sought differences in ninety-day postoperative mortality for patients treated with thoracotomy or video-assisted thoracic surgery (VATS) for descending necrotic mediastinitis (DNM). Sicker patients were more frequently treated with VATS. Although VATS patients had higher complication and reoperation rates, the risk-adjusted difference for ninety-day mortality was not statistically significantly different between thoracotomy and VATS.
When compared to population-based models, a machine learning-based model improved prediction of mortality risk for cardiac surgery patients. The team used electronic health record data and machine learning methods to demonstrate how institutions can build their own mortality prediction models. The models were tested against STS population-based models for five different surgeries, and were found to have higher accuracy, precision, and recall for each of them.
A lab focused on how artificial intelligence technology can improve the treatment of cardiovascular disease has tested the ability of ChatGPT to answer assessment questions from the American Board of Thoracic Surgery. ChatGPT-4 achieved an accuracy of 81.3 percent. The results prove that the AI model shows the ability to understand complex thoracic surgical clinical information, which the authors suggest could be developed into personalized learning platforms for trainees.
This single institution study retrospectively reviewed the outcome of pediatric Ebstein’s anomaly surgical correction. Of the 188 patients with a median (IQR) age of three years (1.6–5.6), 108 had cone reconstruction. Nearly 30 percent of patients required a bidirectional cavopulmonary shunt. Another 12 percent developed recurrent moderate to severe tricuspid regurgitation (TR). There was a lower incidence of recurrent TR in the group undergoing cone reconstruction. The age group of patients did not appear to affect the incidence of recurrent TR, reoperation, or death.
Between 2011 and 2020, 14,704 isolated tricuspid operations were reported in The Society of Thoracic Surgeons Adult Cardiac Surgery Database, and 6,507 cases were identified after excluding emergencies, endocarditis, stenosis, and prior heart transplants. Operative mortality was 7.3 percent, and 1.7 percent in elective patients without heart failure, organ dysfunction, or prior surgery. Heart failure (odds ratio [OR] 1.6), higher Model For End-Stage Liver Disease score, tricuspid replacement (OR 1.56), and annual center volume < 5 cases per year (OR 1.37) were associated with worse operative mortality, suggesting early referral to higher volume centers may improve outcomes.
This article presents a tier-based framework with proposed benchmarks for the development of quality pediatric and congenital heart disease care in resource-limited settings. This was achieved by identifying the most common barriers to care and using a literature review method to determine the most effective solutions.
A team of surgeons at National Heart Hospital in Lusaka, Zambia collaborated with a team from the University of Michigan to complete the first total aortic arch replacement in the country. Despite the patient’s 8 cm aortic dissection, the procedure was uneventful with no complications. This was part of an ongoing effort to strengthen Zambia’s cardiac care teams and resources.
A systematic review of prognostic factors for five-year survival after pulmonary metastasectomy (PM) from colorectal cancer (CRC) identified 11 of 77 preoperative factors as having statistically significant positive effects. These included a solitary metastasis < 2 cm. The disease free interval at twenty-four months did not affect five-year survival. These findings consolidate the evidence and support clinical practice and future research design.
This double-blind, randomized study compared albumin to Ringer's acetate for volume resuscitation. The results showed that the group that was perioperatively administered albumin had a greater blood loss and higher UDBP compared to those who were administered Ringer’s acetate.