JTCVS open最新文献

{"title":"Nationwide analysis of case volume and outcomes in cardiac surgery during the COVID-19 pandemic","authors":"Jean-Luc A. Maigrot BS , Guangjin Zhou PhD , Siran M. Koroukian PhD , Aaron J. Weiss MD, PhD , A. Marc Gillinov MD , Faisal Bakaeen MD , Lars G. Svensson MD, PhD , Edward G. Soltesz MD, MPH","doi":"10.1016/j.xjon.2024.02.024","DOIUrl":"10.1016/j.xjon.2024.02.024","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 200-209"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000640/pdfft?md5=f8ab2377e4241003963ac0d35476b32f&pid=1-s2.0-S2666273624000640-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270224","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}

{"title":"Timeliness of surgery for early-stage lung cancer: Patient factors and predictors","authors":"Jeffrey Zhu MSPH ,&nbsp;Sydney Kantor MBA ,&nbsp;Jiafang Zhang MS ,&nbsp;Rowena Yip PhD, MPH ,&nbsp;Raja M. Flores MD ,&nbsp;Claudia I. Henschke PhD, MD ,&nbsp;David F. Yankelevitz MD","doi":"10.1016/j.xjon.2024.02.019","DOIUrl":"10.1016/j.xjon.2024.02.019","url":null,"abstract":"<div><h3>Objectives</h3><p>Time-to-treatment initiation is an important consideration for patients undergoing thoracic surgery for early-stage lung cancer because delays have the potential to adversely affect outcomes. This study seeks to quantify time-to-treatment initiation for patients with clinical stage I lung cancer, explore patient factors and predictors that lead to an increased time-to-treatment initiation, and compare surgeon perception of appropriate time-to-treatment initiation to the results.</p></div><div><h3>Methods</h3><p>Time-to-treatment initiation was determined for patients enrolled in the Mount Sinai Initiative for Early Lung Cancer Research on Treatment study who underwent surgical resection for clinical stage I lung cancer between March 2016 and December 2021. The following dates were determined: (1) date of first suspicious radiologic imaging, (2) date of first biopsy, and (3) date of surgery. A total of 15 thoracic surgeons who participated in the Mount Sinai Initiative for Early Lung Cancer Research on Treatment were assessed on their perception on time-to-treatment initiation.</p></div><div><h3>Results</h3><p>For 638 patients, median time from first suspicious imaging findings to biopsy was 40 days, biopsy to surgery was 37 days, and suspicious imaging to surgery was 84 days. Significant factors that resulted in longer time-to-treatment initiation in the multivariate analysis were African American or Black race (<em>P</em> = .005), vascular disease (<em>P</em> = .01), and median household income less than $75,000 (<em>P</em> = .04). Although the surgeon's perception was that the average time from biopsy to surgery was 28 days, it was longer for 63.5% of participants; surgeon perception of maximum time between diagnosis and surgery was 84 days and longer for 28.7% of participants.</p></div><div><h3>Conclusions</h3><p>Patient factors such as race, income, and comorbidities were found to have differences in time-to-treatment initiation. Delays to surgery exceeded the expectations of thoracic surgeons.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 325-337"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000548/pdfft?md5=4c68c26ec0edd07d2c5eb95061f0c580&pid=1-s2.0-S2666273624000548-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279442","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}

{"title":"The effect of treatment timing on repeat revascularization in patients with stable ischemic heart disease","authors":"Sean Hardiman PhD, MHA ,&nbsp;Guy Fradet MD, MSc ,&nbsp;Lisa Kuramoto MSc ,&nbsp;Michael Law PhD ,&nbsp;Simon Robinson MB, ChB, MD ,&nbsp;Boris Sobolev PhD","doi":"10.1016/j.xjon.2024.04.009","DOIUrl":"10.1016/j.xjon.2024.04.009","url":null,"abstract":"<div><h3>Objectives</h3><p>In patients with stable ischemic heart disease, there is no evidence for the effect of revascularization treatment timing on the need for repeat procedures. We aimed to determine if repeat revascularizations differed among patients who received coronary artery bypass graft surgery after the time recommended by physicians compared with those who had timely percutaneous coronary intervention.</p></div><div><h3>Methods</h3><p>We identified 25,520 British Columbia residents 60 years or older who underwent first-time nonemergency revascularization for angiographically proven, stable left main or multivessel ischemic heart disease between January 1, 2001, and December 31, 2016. We estimated unadjusted and adjusted cumulative incidence functions for repeat revascularization, in the presence of death as a competing risk, after index revascularization or last staged percutaneous coronary intervention for patients undergoing delayed coronary artery bypass grafting compared with timely percutaneous coronary intervention.</p></div><div><h3>Results</h3><p>After adjustment with inverse probability of treatment weights, at 3 years, patients who underwent delayed coronary artery bypass grafting had a statistically significant lower cumulative incidence of a repeat revascularization compared with patients who received timely percutaneous coronary intervention (4.84% delayed coronary artery bypass grafting, 12.32% timely percutaneous coronary intervention; subdistribution hazard ratio, 0.16, 95% CI, 0.04-0.65).</p></div><div><h3>Conclusions</h3><p>Patients who undergo delayed coronary artery bypass grafting have a lower cumulative incidence of repeat revascularization than patients who undergo timely percutaneous coronary intervention. Patients who want to wait to receive coronary artery bypass grafting will see the benefit of lower repeat revascularization over percutaneous coronary intervention unaffected by a delay in treatment.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 164-174"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624001116/pdfft?md5=c41fdb3883983137ac32d3c05190baf8&pid=1-s2.0-S2666273624001116-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779381","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}

{"title":"Effects of implantation height on the performance of a redo transcatheter aortic valve replacement using a balloon-expandable valve","authors":"Huang Chen PhD ,&nbsp;Milad Samaee PhD ,&nbsp;Pradeep Yadav MD ,&nbsp;Vinod Thourani MD ,&nbsp;Lakshmi Prasad Dasi PhD","doi":"10.1016/j.xjon.2024.02.021","DOIUrl":"https://doi.org/10.1016/j.xjon.2024.02.021","url":null,"abstract":"<div><h3>Objective</h3><p>The use of the transcatheter aortic valve in low-risk patients might lead to a second intervention due to the deterioration of the first 1. Understanding the implantation height is key to an effective redo transcatheter aortic valve replacement treatment.</p></div><div><h3>Methods</h3><p>The effects of implantation height on the performance of a balloon-expandable valve within a self-expandable valve were assessed using hemodynamic testing and particle image velocimetry. The hemodynamic performances, leaflet kinematics, and turbulent shear stresses were measured and compared.</p></div><div><h3>Results</h3><p>When a second balloon-expandable valve was positioned at varying heights relative to the first self-expandable valve, the leaflet motion of the first valve transitioned from free opening and closing to overhanging, and eventually to being entirely pinned to the stent, forming a neo-skirt. When the leaflets of the self-expandable valve could move freely, a decrease in regurgitation fraction was observed, but with an increased pressure gradient across the valve. Flow visualization indicated that the overhanging leaflets disrupted the flow, generating a higher level of turbulence.</p></div><div><h3>Conclusions</h3><p>This study suggests that the overhanging leaflets should be avoided, whereas the other 2 scenarios should be carefully evaluated based on an individual patient's anatomy and the cause of failure of the first valve.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 61-67"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000561/pdfft?md5=af9497c1ab8208ff97c409c0e9b792b3&pid=1-s2.0-S2666273624000561-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141325205","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}

{"title":"Discussion to: Noncomplex ventricular arrhythmia associated with higher freedom from recurrent ectopy at 1 year after mitral repair surgery","authors":"","doi":"10.1016/j.xjon.2024.04.015","DOIUrl":"10.1016/j.xjon.2024.04.015","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 114-115"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624001189/pdfft?md5=bc903bd4103e51fc858ab369764b511d&pid=1-s2.0-S2666273624001189-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140757718","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}

{"title":"National trends, safety, and effectiveness of minimally invasive concomitant chest wall resection for locally advanced lung cancer","authors":"Shawn Purnell MD ,&nbsp;Ayham Odeh MD ,&nbsp;Richard Freeman MD, MBA ,&nbsp;Wissam Raad MD, FACS ,&nbsp;Elliot Servais MD, FACS ,&nbsp;Zaid Abdelsattar MD, MS, FACS","doi":"10.1016/j.xjon.2024.03.016","DOIUrl":"10.1016/j.xjon.2024.03.016","url":null,"abstract":"<div><h3>Objective</h3><p>Concomitant chest wall resection for locally advanced lung cancer is traditionally performed via an open approach. The safety and effectiveness of minimally invasive approaches for chest wall resections are unknown.</p></div><div><h3>Methods</h3><p>We used the National Cancer Database to identify patients undergoing lobectomy/bi-lobectomy with concomitant chest wall resection from 2010 to 2020. We stratified patients into those undergoing a minimally invasive resection (video-assisted thoracoscopic surgery [VATS]/robotic) or open, while accounting for conversions. We also compared VATS with robotic approaches. The main outcomes were length of stay, mortality, readmissions, and overall survival. We used multivariable, Kaplan-Meier and Cox proportional models to identify associations.</p></div><div><h3>Results</h3><p>Of 2837 patients, 756 procedures (26.6%) were started minimally invasive, of which 23.1% were robotic. There were 237 (31.3%) conversions. Patients undergoing a minimally invasive operation were similar in terms of age (65.2 ± 9.8 years vs 66.0 ± 9.9 years), sex, race, tumor histology, and location (all <em>P</em> &gt; .05) but had smaller cancers (5.4 ± 2.6 cm vs 6.2 ± 4.3 cm; <em>P</em> &lt; .001) compared with those undergoing open. They also had shorter length of stay (8.6 ± 7.6 days vs 9.7 ± 9.3 days; <em>P</em> &lt; .001) but similar unadjusted 90-day mortality (8.2% vs 8.0%; <em>P</em> = .999). Neoadjuvant therapy was associated with less minimally invasive approaches (adjusted odds ratio, 0.69; <em>P</em> ≤ .001). Larger cancers were associated with less minimally invasive operations and greater rates of conversions. However, the robotic approach was associated with lower conversion rates than VATS across all tumor sizes. Overall survival was equivalent.</p></div><div><h3>Conclusions</h3><p>The use of minimally invasive approaches to concomitant chest wall resection is increasing. Although conversions to open are common, this approach is safe and is associated with shorter hospital stays. Overall survival is equivalent to the open approach.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 311-324"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000974/pdfft?md5=23e283284243639c052996ec280658de&pid=1-s2.0-S2666273624000974-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775997","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}

{"title":"Quality of life, psychological states, and personality traits in patients with pectus excavatum","authors":"Kohei Matsuda MD ,&nbsp;Daisuke Fujisawa MD ,&nbsp;Kyohei Masai MD ,&nbsp;Naoki Miyazaki ,&nbsp;Shigeki Suzuki MD ,&nbsp;Yu Okubo MD ,&nbsp;Kaoru Kaseda MD ,&nbsp;Keisuke Asakura MD ,&nbsp;Tomoyuki Hishida MD ,&nbsp;Hisao Asamura MD","doi":"10.1016/j.xjon.2024.03.013","DOIUrl":"10.1016/j.xjon.2024.03.013","url":null,"abstract":"<div><h3>Objective</h3><p>The quality of life (QOL) and psychological states of patients with pectus excavatum (PE) have yet to be well understood. This study aimed to evaluate the health-related QOL (HRQOL), psychological states, and personality traits of patients with PE, alongside the associations of these factors with the severity of PE.</p></div><div><h3>Methods</h3><p>A cross-sectional evaluation was prospectively performed in patients scheduled to undergo PE repair surgery between July 2019 and April 2021. The primary outcome was the patients’ HRQOL, and the secondary outcomes were depression, social anxiety, self-efficacy, and personality traits.</p></div><div><h3>Results</h3><p>In total, 129 patients were subjected to analyses. Patients' HRQOL had a lower role component summary score (mean ± standard deviation: 41.8 ± 12.8, <em>P</em> &lt; .001) than the general population controls. Patients' HRQOL had a significantly better physical component summary (54.0 ± 10.4, <em>P</em> &lt; .001) and mental component summary (53.3 ± 8.8, <em>P</em> &lt; .001) than that of the general population. Fourteen patients' (10.9%) and 56 patients' (43.4%) scores indicated the presence of depression and social anxiety disorder, respectively. Patients’ self-efficacy (46.1 ± 11.4, <em>P</em>, .001) and level of extraversion (46.5 ± 11.8, <em>P</em> &lt; .001) were lower than those of the general population. No significant correlation was found between the severity of PE and these scores.</p></div><div><h3>Conclusions</h3><p>Our study revealed that patients with PE had decreased social-role QOL, depressive tendencies, increased social anxiety, lower self-efficacy, and introversion. No correlation between the severity of PE and the patients’ psychological outcomes leads us to conclude that surgical implications of PE should not be decided solely by a physical index.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 355-369"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000925/pdfft?md5=d95808db0e22014c8f8cedb86d5a8ff4&pid=1-s2.0-S2666273624000925-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791091","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}

{"title":"Young infants with symptomatic tetralogy of Fallot: Shunt or primary repair?","authors":"Xin Tao Ye MD ,&nbsp;Soichiro Henmi MD, PhD ,&nbsp;Edward Buratto MBBS, PhD ,&nbsp;Mitchell C. Haverty MS ,&nbsp;Can Yerebakan MD ,&nbsp;Tyson Fricke MBBS, PhD ,&nbsp;Christian P. Brizard MD, MS ,&nbsp;Yves d’Udekem MD, PhD ,&nbsp;Igor E. Konstantinov MD, PhD","doi":"10.1016/j.xjon.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.xjon.2024.04.003","url":null,"abstract":"<div><h3>Objectives</h3><p>The optimal treatment strategy for symptomatic young infants with tetralogy of Fallot (TOF) is unclear. We sought to compare the outcomes of staged repair (SR) (shunt palliation followed by second-stage complete repair) versus primary repair (PR) at 2 institutions that have exclusively adopted each strategy.</p></div><div><h3>Methods</h3><p>We performed propensity score-matched comparison of 143 infants under 4 months of age who underwent shunt palliation at one institution between 1993 and 2021 with 122 infants who underwent PR between 2004 and 2018 at another institution. The primary outcome was mortality. Secondary outcomes were postoperative complications, durations of perioperative support and hospital stays, and reinterventions. Median follow-up was 8.3 years (interquartile range, 8.1-13.4 years).</p></div><div><h3>Results</h3><p>After the initial procedure, hospital mortality (shunt, 2.8% vs PR, 2.5%; <em>P</em> = .86) and 10-year survival (shunt, 95%; 95% confidence interval [CI], 90%-98% vs PR, 90%; 95% CI, 81%-95%; <em>P</em> = .65) were similar. The SR group had a greater risk of early reinterventions but similar rates of late reinterventions. Propensity score matching yielded 57 well-balanced pairs. In the matched cohort, the SR group had similar freedom from reintervention (55%; 95% CI, 39%-68% vs 59%; 95% CI, 43%-71%; <em>P</em> = .85) and greater survival (98%; 95% CI, 88%-99.8% vs 85%; 95% CI, 69%-93%; <em>P</em> = .02) at 10 years, as the result of more noncardiac-related mortalities in the PR group.</p></div><div><h3>Conclusions</h3><p>In symptomatic young infants with TOF operated at 2 institutions with exclusive treatment protocols, the SR strategy was associated with similar cardiac-related mortality and reinterventions as the PR strategy at medium-term follow-up.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 241-256"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624001050/pdfft?md5=634f9db4d1ee51abaafeb9a75e2c24c4&pid=1-s2.0-S2666273624001050-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141323806","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}

{"title":"Multifactorial considerations in frozen elephant trunk selection and treatment strategies for acute type A aortic dissection","authors":"Yang Yu MD, PhD,&nbsp;Lu Liu MD,&nbsp;Enyi Shi MD, PhD,&nbsp;Tianxiang Gu MD, PhD","doi":"10.1016/j.xjon.2024.03.008","DOIUrl":"10.1016/j.xjon.2024.03.008","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Page 39"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000676/pdfft?md5=b2c9c193dee67367526cc176312a7894&pid=1-s2.0-S2666273624000676-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402140","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}

{"title":"Value of nutritional indices in predicting survival free from pump replacement and driveline infections in centrifugal left ventricular assist devices","authors":"Fabian Jimenez Contreras MD ,&nbsp;Bret L. Pinsker MD ,&nbsp;Jason N. Katz MD, MHS ,&nbsp;Stuart D. Russell MD ,&nbsp;Jacob Schroder MD ,&nbsp;Benjamin Bryner MD ,&nbsp;Alexander H. Gunn MD ,&nbsp;Krunal Amin MD ,&nbsp;Carmelo Milano MD","doi":"10.1016/j.xjon.2024.03.017","DOIUrl":"10.1016/j.xjon.2024.03.017","url":null,"abstract":"<div><h3>Objective</h3><p>There is a paucity of data assessing the impact of nutritional status on outcomes in patients supported with the HeartMate 3 (HM3) left ventricular assist device (LVAD).</p></div><div><h3>Methods</h3><p>Patients ≥18 years of age who underwent HM3 LVAD implantation between 2015 and 2020 were identified from a single tertiary care center. The primary outcome assessed was death or device replacement. A secondary outcome of driveline infection was also evaluated. Kaplan-Meier survival analysis and a multivariate Cox-proportional hazards model were used to identify predictors of outcome.</p></div><div><h3>Results</h3><p>Of the 289 patients identified, 94 (33%) experienced a primary outcome and 96 (33%) a secondary outcome during a median follow-up time of 2.3 years. Independent predictors of the primary outcome included peripheral vascular disease (hazard ratio [HR], 3.40; 95% confidence interval [CI], 1.66-6.97, <em>P</em> &lt; .01), diabetes mellitus (HR, 0.46; 95% CI, 0.27-0.80, <em>P</em> &lt; .01), body mass index ≥40 kg/m² (HR, 2.63 per 1 kg/m² increase; 95% CI, 1.22-5.70, <em>P</em> &lt; .05), preoperative creatinine level (HR, 1.86 per 1 mg/dL increase; 95% CI, 1.31-2.65, <em>P</em> &lt; .01), and preoperative prognostic nutritional index (PNI) score (HR, 0.88 per 1-point increase; 95% CI, 0.81-0.96, <em>P</em> &lt; .01). Independent predictors of driveline infection included age at the time of implantation (HR, 0.97; 95% CI, 0.96-0.99, <em>P</em> &lt; .01) and diabetes mellitus (HR, 1.79; 95% CI, 1.17-2.73, <em>P</em> &lt; .01).</p></div><div><h3>Conclusions</h3><p>Preoperative PNI scores may independently predict mortality and the need for device replacement in patients with HM3 LVAD. Routine use of the PNI score during preoperative evaluation and, when possible, supplementation to PNI &gt;33, may be of value in this population.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"19 ","pages":"Pages 175-182"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624001037/pdfft?md5=f03889c7d804c5b6dc86a6f0101433ca&pid=1-s2.0-S2666273624001037-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774685","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}