JTCVS open最新文献_第10页

Commentator Discussion: Fifteen years’ experience of direct bridge with venoarterial extracorporeal membrane oxygenation to heart transplantation 解说员讨论：15年静脉外膜氧合直接桥接心脏移植经验。

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.09.018

引用次数: 0

Validation of the inadequate delivery of oxygen index in an adult cardiovascular intensive care unit 成人心血管重症监护病房氧指数输送不足的验证。

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.09.006

Heather Holman BS , Dimitar Baronov PhD , Jeff McMurray MD , Arman Kilic MD , Marc Katz MD , Sanford Zeigler MD

{"title":"Validation of the inadequate delivery of oxygen index in an adult cardiovascular intensive care unit","authors":"Heather Holman BS , Dimitar Baronov PhD , Jeff McMurray MD , Arman Kilic MD , Marc Katz MD , Sanford Zeigler MD","doi":"10.1016/j.xjon.2024.09.006","DOIUrl":"10.1016/j.xjon.2024.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>Machine learning (ML) may allow for improved discernment of hemodynamics and oxygen delivery compared to standard invasive monitoring. We hypothesized that an ML algorithm could predict impaired delivery of oxygen (IDO<sub>2</sub>) with comparable discrimination to invasive mixed venous oxygen saturation (SvO<sub>2</sub>) measurement.</div></div><div><h3>Methods</h3><div>A total of 230 patients not on mechanical circulatory support (MCS) managed with a pulmonary artery catheter (PAC) were identified from 1012 patients admitted to a single cardiovascular intensive care unit (CVICU) between April 2021 and January 2022. Physiologic data were collected prospectively by the data analytics engine. Inadequate delivery of oxygen (IDO<sub>2</sub>) was defined as SvO<sub>2</sub> ≤50%. Fifty-four patients were used to train the model, which was then validated in 176 patients. Three simulated monitoring situations were constructed by downsampling the physiologic data set to exclude all SvO<sub>2</sub> sources (scenario A); all PAC data but allowing for SvO<sub>2</sub> values (scenario B); and all PAC data, including SvO<sub>2</sub> and cardiac index (CI) (scenario C). The ML platform then calculated the likelihood of IDO<sub>2</sub> for rolling 30-minute intervals and compared these values against the gold standard SvO<sub>2</sub> values using receiver operating characteristic (ROC) curve analysis to establish discriminatory power.</div></div><div><h3>Results</h3><div>A total of 1047 laboratory-validated SvO<sub>2</sub> values were collected for the validation group. The area under the ROC curve for the IDO<sub>2</sub> index was 0.89 (95% confidence interval, 0.87-0.91) with the full data set. When blinded to all PAC and SvO<sub>2</sub> sources, the AUC was 0.78 (95% confidence interval, 0.75-0.81).</div></div><div><h3>Conclusions</h3><div>The IDO<sub>2</sub> index is capable of detecting SvO<sub>2</sub> ≤50% with good discriminatory function in non-MCS CVICU patients in a variety of monitoring situations. Further investigation of IDO<sub>2</sub> detection and clinical endpoints is needed.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 354-361"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discussion to: Association between the proportionality of functional mitral regurgitation and survival after mitral valve operation 讨论到：功能性二尖瓣反流比例与二尖瓣手术后存活率之间的关系

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.07.005

引用次数: 0

Commentator Discussion: Combined simulation and ex-vivo assessment of free-edge length in bicuspidization repair for congenital aortic valve disease 解说员讨论：先天性主动脉瓣疾病双尖修复术中自由边缘长度的联合模拟和离体评估。

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.10.005

引用次数: 0

Commentator Discussion: Is concomitant tricuspid valve repair in patients undergoing robotic mitral valve repair safe and effective? 评论员讨论：接受机器人二尖瓣修复的患者同时进行三尖瓣修复安全有效吗？

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.10.009

引用次数: 0

Commentator Discussion: Malnutrition in adult patients treated with venoarterial membrane oxygenation: A descriptive cohort study 讨论：静脉动脉膜氧合治疗的成年患者营养不良：一项描述性队列研究。

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.10.011

引用次数: 0

Commentator Discussion: Predicting operative mortality in patients who undergo elective, open thoracoabdominal aortic aneurysm repair 评论员讨论：预测择期胸腹主动脉瘤开腹修补术患者的手术死亡率。

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.09.024

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Evaluating the long-term efficacy of primary surgical repair in communicating Debakey IIIB chronic dissecting aortic aneurysms 原发性手术修复交通性Debakey IIIB型慢性夹层主动脉瘤的远期疗效评价。

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.08.001

FNU Venjhraj MBBS , Ajeet Singh MBBS , Ravi Das MBBS , Ashvin Kumar MBBS

引用次数: 0

RBT-1 reduces blood product utilization in patients undergoing nonemergency coronary artery bypass grafting and/or valve surgery RBT-1 可减少接受非急诊冠状动脉旁路移植术和/或瓣膜手术患者的血液制品使用量

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.06.019

Charles A. Mack MD , Michael Jessen MD , Andre Lamy MD , Ashish K. Khanna MD , Kevin Lobdell MD , Rakesh Arora MD , Jeannette Rodriguez PhD , Stacey Ruiz PhD , Bhupinder Singh MD

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The relationship of sex and aortic diameter at the time of acute type A aortic dissection 急性A型主动脉夹层时性别与主动脉直径的关系。

JTCVS open Pub Date : 2024-12-01 DOI: 10.1016/j.xjon.2024.07.022

Lamia Harik MD, Mario Gaudino MD, PhD, Mohammed Rahouma MD, Arnaldo Dimagli MD, Roberto Perezgrovas-Olaria MD, Kevin R. An MD, Talal Alzghari MD, Giovanni Soletti Jr. MD, Jordan Leith BS, Gianmarco Cancelli MD, Charles Mack MD, Leonard N. Girardi MD, Christopher Lau MD

{"title":"The relationship of sex and aortic diameter at the time of acute type A aortic dissection","authors":"Lamia Harik MD, Mario Gaudino MD, PhD, Mohammed Rahouma MD, Arnaldo Dimagli MD, Roberto Perezgrovas-Olaria MD, Kevin R. An MD, Talal Alzghari MD, Giovanni Soletti Jr. MD, Jordan Leith BS, Gianmarco Cancelli MD, Charles Mack MD, Leonard N. Girardi MD, Christopher Lau MD","doi":"10.1016/j.xjon.2024.07.022","DOIUrl":"10.1016/j.xjon.2024.07.022","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate sex differences in patients undergoing repair of acute type A aortic dissection (ATAAD).</div></div><div><h3>Methods</h3><div>Sex-stratified, single-center cohort study of patients undergoing ATAAD repair from 1997 to 2022. The primary outcome was aortic diameter at time of presentation with ATAAD. Secondary outcomes were mortality, myocardial infraction, stroke, hemodialysis, tracheostomy, re-exploration for bleeding, a composite of major adverse events, and long-term survival.</div></div><div><h3>Results</h3><div>In 390 consecutive patients (150 women), men were younger than women (61.0 years; interquartile range [IQR], 50-70 years vs 70.5 years; IQR, 59-78 years; <em>P</em> < .001), had higher body mass index (28.6; IQR, 25.1-32.3 vs 25.4; IQR, 21.9-29.2; <em>P</em> < .001), more frequent peripheral vascular disease (11.7% vs 4.7%; <em>P</em> = .03), renal insufficiency (36.7% vs 22%; <em>P</em> = .003), malperfusion (34.2% vs 18.7%; <em>P</em> = .007), and smoking history (65% vs 44%; <em>P</em> < .001). There was no sex difference in median aortic diameter at the time of ATAAD (men: 5.3 cm; IQR, 4.9-6.1 cm and women: 5.2 cm; IQR, 4.6-5.9 cm; <em>P</em> = .12) even when adjusted for body mass index (men: 5.7 cm; IQR, 5.4-6.1 cm and women: 5.4 cm; IQR, 5.4-6.1 cm; <em>P</em> = .19). There was no sex difference in mortality (4.6% vs 6.0%; <em>P</em> = .70), major adverse events, or 10-year survival (50.3% vs 58.5%; <em>P</em> = .13). On multivariable analysis, there was no interaction between aneurysm size and sex (interaction <em>P</em> = .62). Sex was not associated with major adverse events (odds ratio, 0.75; 95% CI, 0.07-7.39; <em>P</em> = .81).</div></div><div><h3>Conclusions</h3><div>There was no sex difference in aneurysm size at the time of presentation of ATAAD, even after adjustment for body mass index, and no interaction between aneurysm size and sex, suggesting that aortic diameter remains a reasonable criterion for intervention irrespective of sex.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 114-122"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0