The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2022 Update on Outcomes and Research

Kim, Karen M.; Arghami, Arman; Habib, Robert H.; Daneshmand, Mani A.; Parsons, Niharika; Elhalabi, Zouheir; Krohn, Carole; Thourani, Vinod H.; Bowdish, Michael E.

doi:10.1016/j.athoracsur.2022.12.033

Cited by 72 publications

(35 citation statements)

References 36 publications

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“…Noteworthy in 2023 are reports that morbidity and survival after most cardiac operations, including complex aortic procedures, continue to improve. 13 Improved survival has elevated the importance of patient-centered outcomes of which cognitive recovery is a core metric. 14,15 Optimizing such neurologic outcomes can be particularly challenging for aortic surgery.…”

Section: A Methods To the Madness—cognitive Function After Hypothermi...mentioning

confidence: 99%

Noteworthy in Cardiothoracic Surgery 2023

Rove,

Cain,

Hoffman

et al. 2024

Semin Cardiothorac Vasc Anesth

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Noteworthy in Cardiothoracic Surgery 2023 summarizes a few of the most high-impact trials and provocative trends in cardiothoracic surgery and transplantation this past year. Transplantation using organs procured from donation after circulatory death (DCD) continues to increase, and the American Society of Transplant Surgeons released recommendations on best practices in 2023. We review a summary of data on the impact of DCD on heart and lung transplantation. There has been increased interest in extracorporeal life support (ECLS), particularly after the COVID-19 pandemic, and we review the results of the highly discussed ECLS-SHOCK trial, which randomized patients in cardiogenic shock with planned revascularization to ECLS vs usual care. With improving survival outcomes in complex aortic surgery, there is a need for higher-quality evidence to guide which cooling and cerebral perfusion strategies may optimize cognitive outcomes in these patients. We review the short-term outcomes of the GOT ICE trial (Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest), a multicenter, randomized controlled trial of three different nadir temperatures, evaluating outcomes in cognition and associated changes in functional magnetic resonance imaging. Finally, both the Society of Thoracic Surgeons (STS) and the American College of Cardiology, American Heart Association, American College of Chest Physicians and Heart Rhythm Society (ACC/AHA/ACCP/HRS) updated atrial fibrillation guidelines in 2023, and we review surgically relevant updates to the guidelines and the evidence behind them.

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Section: A Methods To the Madness—cognitive Function After Hypothermi...mentioning

confidence: 99%

Noteworthy in Cardiothoracic Surgery 2023

Rove,

Cain,

Hoffman

et al. 2024

Semin Cardiothorac Vasc Anesth

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“…In the surgical cohort, close to one-third of patients had aortic root enlargement (7%) or received a sutureless valve (22%), rates that are comparable with current surgical practices. 13,14 However, the rate of aortic root enlargement could be considered too low in this anatomic population. In the TAVR cohort, almost two-thirds of patients received a supra-annular prosthesis.…”

Section: The Present Studymentioning

confidence: 99%

Incidence, Implications, and Treatment of Patients With Severe Aortic Stenosis and Small Aortic Annulus

Herrmann,

Desai

2024

Circulation

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“…Valve combined coronary artery bypass graft (CABG) operation still accounts for a significant proportion of adult cardiac surgery according to the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) in 2021 (1). Particularly, patients receiving valve replacement (VR) + CABG exhibit clinical features that generally place them at a higher risk than patients receiving valve operations or CABG alone.…”

Section: Introductionmentioning

confidence: 99%

Quantitative flow ratio-guided versus angiography-guided operation for valve disease accompanying coronary heart disease

Yan

Wang²,

Zheng³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundValve replacement combined with coronary artery bypass graft (CABG) operation (VR + CABG) is usually associated with higher mortality and complication rates. Currently, angiography remains the most commonly used approach to guide CABG. The aim of this study is to investigate whether a quantitative flow ratio (QFR)-guided strategy can improve the clinical outcomes of VR + CABG.MethodsPatients (n = 536) treated by VR + CABG between January 2018 and December 2021 were retrospectively assessed. In 116 patients, all lesions were revascularized entirely based on QFR (the QFR-guided group), whereas in 420 patients, all lesions were revascularized entirely based on angiography (the angiography-guided group). To minimize selection bias between the 2 groups, propensity score matching was performed at a ratio of 1:2. The primary endpoint of the study was the rate of major adverse cardiac and cerebrovascular events (MACCE) at 1-year, which was defined as a composite of cardiac mortality, myocardial infarction (MI), any repeat revascularization, and stroke.ResultsNo statistically significant differences were observed in the baseline clinical characteristics between the QFR-guided and angiography-guided groups after propensity score matching. The mean age of all patients was 66.2 years [standard deviation (SD) = 8.3], 370 (69%) were men, the mean body-mass index of the population was 24.8 kg/m2 (SD = 4.5), 129 (24%) had diabetes, and 229 (43%) had angina symptoms. When compared with the angiography-guided group, the QFR-guided group had a significantly shorter operative time (323 ± 60 min vs. 343 ± 71 min, P = 0.010), extra corporal circulation time (137 ± 38 min vs. 155 ± 62 min, P = 0.004), clamp time (73 ± 19 min vs. 81 ± 18 min, P < 0.001), and less intraoperative bleeding volume (640 ± 148 ml vs. 682 ± 166 ml, P = 0.022). Compared with the angiography-guided group, the 1-year MACCE was significantly lower in the QFR-guided group (6.9% vs. 14.7%, P = 0.036, hazard ratio = 0.455, 95% confidence interval: 0.211–0.982).ConclusionOur results raise the hypothesis that among patients who undergo VR + CABG, QFR-guided strategy is associated with optimized surgical procedure and a superior clinical outcome, as evidenced by a lower rate of MACCE at 1-year compared with conventional angiography-guided strategy.

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The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2022 Update on Outcomes and Research

Cited by 72 publications

References 36 publications

Noteworthy in Cardiothoracic Surgery 2023

Noteworthy in Cardiothoracic Surgery 2023

Incidence, Implications, and Treatment of Patients With Severe Aortic Stenosis and Small Aortic Annulus

Quantitative flow ratio-guided versus angiography-guided operation for valve disease accompanying coronary heart disease

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