Journal of Cardiac Surgery最新文献

{"title":"Nudge Theory Can Be Used to Optimise Cardiac Surgery Inpatient Management","authors":"Aashray K. Gupta,&nbsp;Joshua G. Kovoor,&nbsp;Stephen Bacchi","doi":"10.1155/2023/7291773","DOIUrl":"10.1155/2023/7291773","url":null,"abstract":"<div>\u0000 <p>Nudge theory has influenced the behaviour of millions of individuals across the world; however, the potential power of this approach has yet to be fully utilised in the field of inpatient cardiac surgery. The nudge theory also presents multiple nonalert choice architecture modifications that may be employed. Choice architecture is already influencing decisions made in hospitals every day, whether it has been deliberately designed to promote beneficial behaviours or not. Decision making for cardiac surgery inpatients is already subject to inherent choice architectures, which may be amenable to nudges. The types of choices to which nudges may be employed in the inpatient surgical setting are numerous and may be relevant to medical officers, nursing staff, allied health staff, and patients. Through the strategic development and robust evaluation of choice architecture modification, using the principles of the nudge theory, further optimisation of cardiac surgery inpatient management may be achieved.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7291773","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44559394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Role of Extracellular CIRP in Total Aortic Arch Replacement under Hypothermic Circulatory Arrest","authors":"Ke Chen,&nbsp;Dongxu Wang,&nbsp;Yuanchen He,&nbsp;Minhua Fang,&nbsp;Peng Hou,&nbsp;Yiming Tan,&nbsp;Yu Liu,&nbsp;Yan Jin,&nbsp;Liming Yu,&nbsp;Yong Zhang","doi":"10.1155/2023/6178343","DOIUrl":"10.1155/2023/6178343","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. To investigate the potential role of extracellular cold-inducible RNA-binding protein (CIRP) in total aortic arch replacement under hypothermic circulatory arrest. <i>Methods</i>. The serum extracellular CIRP levels at five time points in 96 patients with Stanford A aortic dissection were detected. Overall change trend of CIRP levels at five time points was described, and the risk factors for 30-day mortality after surgery were analyzed. <i>Results</i>. The serum extracellular CIRP levels increased gradually after surgery, starting to rise significantly at approximately 12 h postoperatively, reaching or approaching a peak at approximately 24 h postoperatively, and ceasing to rise significantly after approximately 48 h postoperatively. Age, troponin-I, urodilatin, cooling time, cardiopulmonary bypass time, cross-clamp time, duration of surgery, and CIRP level at the end of surgery in the death group were significantly higher than those in the survival group. Multivariable analysis indicated that CIRP level at the end of surgery, age, urodilatin, and cross-clamp time were independent risk factors for postoperative 30-day mortality. <i>Conclusion</i>. Extracellular CIRP is closely related to the perioperative condition and prognosis of hypothermic circulatory arrest.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6178343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41568122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Echocardiographic Metrics Predict Tricuspid Insufficiency in Pediatric Ebstein Anomaly","authors":"Wei Liu,&nbsp;Chen Wen,&nbsp;Jin Shentu,&nbsp;Yuqi Zhang,&nbsp;Zhongqun Zhu,&nbsp;Lijun Chen,&nbsp;Huiwen Chen","doi":"10.1155/2023/7796087","DOIUrl":"10.1155/2023/7796087","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. The tricuspid anterior leaflet is considered important in most repair techniques for Ebstein anomaly (EA). We aim to assess the anterior leaflet morphology using novel metrics and investigate the association of the morphology with recurrent moderately severe or greater tricuspid regurgitation (TR). <i>Methods</i>. Seventy-four paediatric patients with EA undergoing cone reconstruction (CR) between 2010 and 2021 were included. Anterior leaflet mobility (ALM) and anterior leaflet length (ALL) were remeasured on preoperative 2D echocardiography. The prediction accuracies of ALM and ALL-I (ALL indexed to body surface area) for recurrent TR were evaluated using receiver operating characteristic (ROC) curve analyses. <i>Results</i>. The median age of patients was 3.3 years (interquartile range, 1.9–7.1 years). Both ALM and ALL-I correlated with the Carpentier type and GOSH score. Nine patients (12.2%) developed recurrent TR during the one-year follow-up. By univariable logistic regression analyses, ALM (odds ratio [OR], 0.89; 95% CI [confidence interval], 0.82–0.96; <i>p</i> = 0.003) and ALL-I (OR, 1.39; 95% CI, 1.08–1.78; <i>p</i> = 0.011) were risk factors for recurrent TR. ROC curve analyses showed that ALM (AUC = 0.81) and ALL-I (AUC = 0.77) had better predictive performance for recurrent TR compared with the GOSH score (AUC = 0.68), the Carpentier type (AUC = 0.67), and preoperative TR severity (AUC = 0.58), and the combinations of ALM and ALL-I (AUC = 0.87) improved the predictive performance compared with ALM or ALL-I alone. <i>Conclusions</i>. ALM and ALL-I can help optimize evaluation in the anterior leaflet morphology and predict recurrent TR after CR in pediatric EA.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7796087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49452918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in Racial Disparities in Heart Transplantation following the Heart Allocation Policy Change","authors":"Curry Sherard,&nbsp;Savannah Skidmore,&nbsp;Khaled Shorbaji,&nbsp;Brett A. Welch,&nbsp;Krishna Bhandari,&nbsp;Arman Kilic","doi":"10.1155/2023/5061721","DOIUrl":"10.1155/2023/5061721","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Heart transplantation (HT) is a definitive therapy for refractory heart failure, making it the gold-standard treatment for recipients with end-stage disease. Heart allocation policy (HAP) in the United States was changed on October 18th, 2018. The aim of this study was to assess the effect of the new policy on racial disparities in heart transplantation (HT) outcomes. <i>Methods</i>. The United Network for Organ Sharing (UNOS) registry was used to identify adult recipients undergoing isolated HT between 2010 and 2021. Recipients were stratified into pre-HAP (January 2010 to September 2018) vs. post-HAP (October 2018 to September 2021). Recipient race was classified as White, Black, Hispanic, or other. The primary outcome was post-HT mortality. Cox proportional hazard models were used for risk-adjustment in evaluating the independent effect of race on post-HT mortality. <i>Results</i>. A total of 27,403 recipients underwent HT in 143 centers during study period. The proportion of non-Whites undergoing HT increased in the post-HAP era: (pre-HAP: White 66.0%, Black 21.2%, Hispanic 8.2%, Other 4.6% versus post-HAP: White 62.5%, Black 23.2%, Hispanic 9.5%, Other 4.8%; <i>p</i> &lt; 0.001). In risk-adjusted analysis, Black recipients were at higher risk of post-HT mortality in the pre-HAP era (HR 1.31, 95% CI 1.22–1.41; <i>p</i> &lt; 0.001) but not in the post-HAP era (HR 1.12, 95% CI 0.03–1.34; <i>p</i> = 0.222) compared to White recipients. Other non-White recipients had comparable risk-adjusted post-HT mortality rates compared to White recipients both in the pre-HAP and post-HAP eras. <i>Conclusions</i>. Under the new heart allocation system, a higher percentage of recipients are non-White. In addition, racial disparities in HT outcomes have improved with Black recipients no longer having an increased risk-adjusted mortality following HT.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5061721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48837199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mildly Elevated Pulmonary Artery Systolic Pressure is Associated with Extracorporeal Membrane Oxygenation Support after Heart Transplantation","authors":"Li Yuan,&nbsp;Wenrui Ma,&nbsp;Jie Cui,&nbsp;Junjiang Liu,&nbsp;Zhaohua Yang,&nbsp;Shouguo Yang,&nbsp;Hongqiang Zhang,&nbsp;Fanshun Wang,&nbsp;Huan Liu,&nbsp;Chunsheng Wang,&nbsp;Xiaoning Sun","doi":"10.1155/2023/8877476","DOIUrl":"10.1155/2023/8877476","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Pulmonary hypertension is a well-known risk factor for hemodynamic instability after heart transplantation. However, it remains unclear whether a mild elevation of pulmonary artery systolic pressure (PASP) is associated with higher risks of graft dysfunction and resultant extracorporeal membrane oxygenation (ECMO) support. <i>Methods</i>. From 2016 to 2021, 102 adult recipients undergoing orthotopic heart transplantation at our institution were investigated (mean age, 48.5 ± 13.2 years; 22.5% female). This study cohort was stratified into 3 groups based on the PASP measured by right heart catheterization before surgery: &gt;50 mmHg, 35–50 mmHg, and &lt;35 mmHg. The primary end point was ECMO support after procedure. <i>Results</i>. ECMO was implemented in 24 (23.5%) patients due to difficult weaning from cardiopulmonary bypass or cardiac low output in the intensive care unit, which was likely to be associated with higher mortality (<i>P</i> = 0.053). Age, gender, comorbidities, preoperative medications, and graft ischemia time were comparable across the 3 groups. The use of ECMO was significantly more common in patients with baseline PASP &gt;50 mmHg (11/36, 30.6%) and 35–50 mmHg (12/38, 31.6%), while only 1 (3.6%) patient with baseline PASP &lt;35 mmHg required ECMO support after transplant (<i>P</i> = 0.007). Multivariate logistic models demonstrated that PASP (odds ratio = 2.34; <i>P</i> = 0.028) and cardiopulmonary bypass time (odds ratio = 1.01; <i>P</i> &lt; 0.001) were independent risk factors for postoperative ECMO. <i>Conclusions</i>. A mild elevation of pretransplant PASP (e.g., 35–50 mmHg) is related to low cardiac output and subsequent ECMO after heart transplantation, for which prompt administration of vasodilators before transplant may be protective.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8877476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46929107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-Printed Models for Multidisciplinary Discussion of Congenital Heart Diseases","authors":"Mi Kyoung Song,&nbsp;Sang Yoon Lee,&nbsp;Soon Ho Yoon,&nbsp;Jeong-Wook Seo","doi":"10.1155/2023/8899573","DOIUrl":"10.1155/2023/8899573","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Congenital heart defects (CHDs) are complex three-dimensional (3D) lesions with variable anatomies that present therapeutic challenges. The application of a patient-specific3D-printed model in preoperative planning and communication in medical practice can contribute to a complete understanding of the intracardiac and vascular anatomy. This study aimed to prospectively investigate the clinical value of a 3D CHD model in multidisciplinary discussions. <i>Methods</i>. Between August 2019 and April 2021, 19 patients with complex CHDs before surgery were prospectively enrolled in this study. Eight to 14 medical specialists participated in multidisciplinary discussions using patient-specific 3D models. A subjective satisfaction questionnaire, comprising 12 questions to be answered on a 10-point scale, was distributed. <i>Results</i>. Twenty 3D-printed anatomic models of 19 patients were used. The median age and weight of the enrolled patients were 0.8 years (range, 5 days to 43 years) and 9.6 kg (range, 2.8–54 kg), respectively. The most common underlying disease was a double outlet of the right ventricle. The mean scores for understanding spatial orientation, ease of communication between clinicians during discussions, prediction of surgical complications, and information additional to conventional 2D imaging were 9.4 ± 1.1, 9.4 ± 0.9, 9.0 ± 1.1, and 9.2 ± 0.4, respectively. The competency and comfort scores for each patient’s surgical plan increased significantly after using the 3D-printed model (from 6.2 ± 1.6 to 9.2 ± 0.9, <i>p</i> &lt; 0.001 and from 6.3 ± 1.6 to 9.2 ± 0.8, <i>p</i> &lt; 0.001, respectively). <i>Conclusions</i>. Patient-specific 3D models, for patients with complex CHDs, improved the understanding of the disease and facilitated multidisciplinary discussions and surgical decision-making. However, because outcomes were mainly evaluated by subjective reports, the possibility of other unknown factors affecting the outcomes should be considered. Trial Registration. This trial is registered with D-1904-031-1024.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8899573","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45345058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Alternative Peripheral and Transfemoral Approaches for Transcatheter Aortic Valve Replacement: A Meta-Analysis of Propensity-Matched Studies","authors":"Daniel McGrath,&nbsp;Charley Sun,&nbsp;Masashi Kawabori,&nbsp;Yong Zhan","doi":"10.1155/2023/9030702","DOIUrl":"10.1155/2023/9030702","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Transfemoral (TF) access is the gold standard for transcatheter aortic valve replacement (TAVR). Alternative peripheral (AP) artery access such as the carotid or axillary artery is considered when the feasibility of femoral access is in doubt. The outcomes comparison of these 2 approaches is unclear due to limited sample sizes in prior studies. Our aim is to compare the clinical outcomes of TF- and AP-TAVR by conducting a meta-analysis of propensity-matched studies. <i>Methods</i>. The PubMed, EMBASE, and Cochrane Library databases from inception up to and including February 2022 were searched by 3 separate researchers to identify articles reporting propensity-matched, comparative data on TF vs. AP-TAVR. Clinical outcomes were extracted from the articles and pooled for analysis. <i>Results</i>. Seven prior studies, including 9,004 patients, were included in our study, with 6,729 in the TF group and 2,275 in the AP group. In all studies, the baseline characteristics of the patients were highly propensity-matched with the full Newcastle-Ottawa scale. Meta-analysis revealed higher in-hospital/30-day mortality (3.3% vs. 4.4%; OR 0.69; 95% CI (0.51, 0.94); <i>P</i> = 0.02) as well as the incidence of stroke (1.9% vs. 3.5%; OR 0.60; 95% CI (0.43, 0.84); <i>P</i> = 0.003) for the AP group. There were no significant differences in the incidence of major vascular complications, pacemaker implantation, bleeding, or acute kidney injury. <i>Conclusions</i>. Our meta-analysis of propensity-matched studies showed AP-TAVR contains an additional 1.1% risk of early mortality and an additional 1.6% risk of stroke compared to TF-TAVR. These risks should be considered when deciding on access.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9030702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45650828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Medicare Reimbursement for Adult Cardiothoracic Surgery Procedures: 2007 to 2020","authors":"Keyana Zahiri,&nbsp;Aditya Khurana,&nbsp;Laura Scrimgeour,&nbsp;Adam E. M. Eltorai","doi":"10.1155/2023/2790790","DOIUrl":"10.1155/2023/2790790","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Cardiovascular disease has been the leading cause of death in the US for decades. Over half a million cardiothoracic surgery procedures are performed per year, with an increasingly aging population and rising healthcare costs. The purpose of this study was to evaluate trends in Medicare reimbursement rates from 2007 to 2020 for various cardiothoracic surgery procedures. <i>Methods</i>. The Centers for Medicare &amp; Medicaid Services Physician Fee Schedule Look-Up Tool was queried for common procedural terminology codes for 119 common cardiothoracic surgery procedures to obtain reimbursement data by year. Procedures were organized into cardiac, CABG, and thoracic subgroups. All monetary data were adjusted for inflation to 2020 US dollars. Adjusted data were analyzed to calculate compound annual growth rates (CAGR), average annual change, and total percent change for each procedure. <i>Results</i>. After adjusting for inflation, the reimbursement rates for cardiothoracic surgery procedures decreased by 10.20% on average. Reimbursement rates for cardiac, CABG, and thoracic surgical procedures decreased by 8.74%, 14.46%, and 10.94%, respectively. The mean annual change overall was −$14.47, and the CAGR was 0.82%. CABG procedures had the greatest decrease in CAGR (−1.11%), annual change (−$30.30), and total percent change (−14.46%). <i>Conclusions</i>. Medicare reimbursements for cardiothoracic surgery procedures steadily decreased from 2007 to 2020, with CABG procedures experiencing the highest percentage of decline. Dissemination of these findings is crucial to raising awareness for healthcare administrators, surgeons, insurance companies, and policymakers to ensure the accessibility of these procedures for high-quality cardiothoracic surgery care in the United States.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/2790790","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41869206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Factors Influencing Thoracic Deformities after Median Sternotomy in Infants Who Underwent Congenital Cardiac Surgery","authors":"Jian-Feng Liu,&nbsp;Wen-Hao Lin,&nbsp;Yu-Kun Chen,&nbsp;Qiang Chen,&nbsp;Hua Cao","doi":"10.1155/2023/8450105","DOIUrl":"10.1155/2023/8450105","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To investigate the incidence of thoracic deformities after median sternotomy in infants who underwent congenital cardiac surgery and determine its influencing factors. <i>Methods</i>. This was a single-center retrospective study. A total of 156 infants who underwent congenital cardiac surgery with median sternotomy in a provincial hospital in China from September 2020 to January 2022 were included. Depending on whether thoracic deformities occurred, the patients were classified into the thoracic deformity group and the no thoracic deformity group. Relevant data were retrieved through an electronic medical record system, and statistical comparisons and analyses were performed. <i>Results</i>. The incidence of postoperative thoracic deformities in this cohort was 10.9%. Sternal pins for auxiliary sternal fixation were used in eighty-nine infants. After analysis, it was found that age at operation (1.9 ± 0.9 vs. 3.7 ± 1.2, <i>P</i> &lt; 0.001) and weight-for-age <i>Z</i>-scores (−2.0 ± 0.7 vs. −1.4 ± 0.7, <i>P</i> = 0.001) of the thoracic deformity group were significantly lower than those of the no thoracic deformity group. In addition, sternal pin use was significantly higher in the no thoracic deformity group than in the thoracic deformity group (61.9% vs. 17.6%, <i>P</i> = 0.001). Univariable analysis showed that age at operation (OR, 4.74; 95% CI, 2.38–9.46; <i>P</i> &lt; 0.001) and weight-for-age <i>Z</i>-scores (OR, 4.40; 95% CI, 1.74–11.12; <i>P</i> = 0.002) were significant risk factors for postoperative thoracic deformity. Using sternal pins for auxiliary sternal fixation was an important protective factor (OR, 7.57; 95% CI, 2.08–27.59; <i>P</i> = 0.003). <i>Conclusions</i>. In this study, 10.9% of infants undergoing congenital cardiac surgery through a median sternotomy developed thoracic deformities after surgery. Younger age at operation and poor nutritional conditions may be risk factors for postoperative thoracic deformity. Sternal pin-assisted fixation has a positive effect on the prevention of thoracic deformities.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8450105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44589481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical Predictors of New-Onset Atrial Fibrillation after Ascending Aorta Replacement Surgery in Acute Type A Aortic Dissection Patients","authors":"Jian Shi,&nbsp;Yong-Qing Cheng,&nbsp;Xi-Yu Zhu,&nbsp;Ze-Yi Zhou,&nbsp;Yi Jiang,&nbsp;Yun-Xing Xue,&nbsp;Hai-Long Cao,&nbsp;Dong-Jin Wang","doi":"10.1155/2023/2612292","DOIUrl":"10.1155/2023/2612292","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. This study aimed to determine the risk factors of new-onset postoperative atrial fibrillation after ascending aortic replacement in acute type A aortic dissection patients, with emphasis on biochemical parameters. <i>Methods</i>. From Jan 2020 to Dec 2021, a total of 435 acute type A aortic dissection patients who underwent ascending aortic replacement and without a history of atrial fibrillation were retrospectively analyzed in this study. Perioperative data of these patients were obtained from the hospital’s database. The 30-day follow-up was via telephone interviews. The multivariate regression analysis was used to identify risk factors that may be predictive of postoperative atrial fibrillation. <i>Results</i>. 218 (50.1%) patients experienced postoperative atrial fibrillation after ascending aorta replacement surgery. Older age (OR = 1.081 (1.059–1.104), <i>p</i> &lt; 0.001), higher total bile acid (OR = 1.064 (1.024–1.106), <i>p</i> <i>=</i> 0.002), glucose (OR = 1.180 (1.038–1.342), <i>p</i> <i>=</i> 0.012), and serum potassium (OR = 2.313 (1.078–4.960), <i>p</i> <i>=</i> 0.031) were identified by multivariate regression analysis as risk factors of postoperative atrial fibrillation. The multivariate regression analysis prediction model incorporating these four factors had a good prediction effect (AUC = 0.769 (0.723–0.816), <i>p</i> &lt; 0.001). <i>Conclusions</i>. Older age, higher total bile acid, glucose, and serum potassium were risk factors of postoperative atrial fibrillation after ascending aortic replacement surgery in acute type A aortic dissection patients.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/2612292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64792546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}