The Year in Cardiovascular Surgery

Abstract

A comprehensive review of articles on cardiovascular surgery in major general and cardiovascular journals published in 2005 identified a large number that were scientifically sound and broadly relevant. The scientific quality of the 43 articles chosen as most likely to affect the future practice of cardiovascular specialists made it difficult to identify a single work as the "outstanding cardiovascular surgical article of 2005." However, the "most valuable topic award" clearly goes to four articles that distill down and validate multivariable model information into bedside risk prediction tools that quantitate:• The natural history of patients with prior coronary artery bypass grafting (CABG) using coronary angiography. • Operative mortality and five-year survival in patients with low ejection fraction (EF) using five clinical variables. • Major infection after CABG using preoperative variables with or without intraoperative variables. • Operative risk for aortic and mitral valve surgery using clinical information.Careful use of these scores to adjust estimates for differences in outcomes in care environments that develop (and care providers who apply) the predictive tool will infuse quantitative thinking into physician deliberation and provide patients with information describing personalized risks and benefits to inform their deliberations about an operation.

Letalidade por doenças isquêmicas do coração no Estado do Rio de Janeiro no período de 1999 a 2003

“…Recently, CABG lethality rates reported by surgeons in the United States varied from 1.9% in low volume hospitals (up to 150 surgeries/year), to 0.78%, in those with large volumes (628 or more surgeries/year) 19 . In the state of Rio de Janeiro, average CABG lethality rates between 1999 and 2003 were 7.6% (Table 1).…”

Myocardial metabolism assessed by microdialysis: A prospective randomized study in on- and off-pump coronary bypass surgery

“…The Veteran Administration started one in 2002, targeting 2200 cases. By 2005, more than 8800 patients were screened but only 1327 randomized [6]. Even this number might be too low to assess those end-points.…”