Scholars@Duke
Peter Kent Smith

Peter Kent Smith

Mary and Deryl Hart Distinguished Professor of Surgery, in the School of Medicine
Surgery, Cardiovascular and Thoracic Surgery
smith058@mc.duke.edu
Box 3442 Med Ctr, Durham, NC 27710
127 Baker House, Durham, NC 27710

Scholarly Works - Journal articles

Quality of life after mitral valve surgery: Results from the Cardiothoracic Surgical Trials Network.

Journal article J Thorac Cardiovasc Surg · March 2026 OBJECTIVE: To understand patterns and patient factors associated with health status recovery after mitral valve surgery. METHODS: Patient-level data from 3 multicenter randomized trials of mitral valve surgery were harmonized, with heart failure-specific h ... Full text Link to item Cite

Association of tricuspid regurgitation with clinical events and quality of life after surgery for severe ischemic mitral regurgitation.

Journal article JTCVS Struct Endovasc · September 2024 BACKGROUND: The clinical consequences of coexistent tricuspid regurgitation (TR) in patients with severe ischemic mitral regurgitation (IMR) remain unclear. We examined the association of baseline TR severity with outcomes after mitral valve (MV) surgery f ... Full text Link to item Cite

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With and Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials.

Journal article Circulation · April 23, 2024 BACKGROUND: Diabetes may be associated with differential outcomes in patients undergoing left main coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The aim of this study was to investigate ... Full text Link to item Cite

The impact of perioperative stroke and delirium on outcomes after surgical aortic valve replacement.

Journal article J Thorac Cardiovasc Surg · February 2024 OBJECTIVE: The effects of stroke and delirium on postdischarge cognition and patient-centered health outcomes after surgical aortic valve replacement (SAVR) are not well characterized. Here, we assess the impact of postoperative stroke and delirium on thes ... Full text Link to item Cite

Percutaneous Coronary Intervention vs Coronary Artery Bypass Graft Surgery for Left Main Disease in Patients With and Without Acute Coronary Syndromes: A Pooled Analysis of 4 Randomized Clinical Trials.

Journal article JAMA Cardiol · July 1, 2023 IMPORTANCE: Patients with left main coronary artery disease presenting with an acute coronary syndrome (ACS) represent a high-risk and understudied subgroup of patients with atherosclerosis. OBJECTIVE: To assess clinical outcomes after PCI vs CABG in patie ... Full text Link to item Cite

Comparing Consumer-Directed Hospital Rankings With STS Adult Cardiac Surgery Database Outcomes.

Journal article Ann Thorac Surg · February 2023 BACKGROUND: Public interest in stratifying hospital performance has led to the proliferation of commercial, consumer-oriented hospital rankings. In cardiac surgery, little is known about how these rankings correlate with clinical registry quality ratings. ... Full text Link to item Cite

A Randomized Trial of Mesenchymal Stromal Cells for Moderate to Severe Acute Respiratory Distress Syndrome from COVID-19.

Journal article Am J Respir Crit Care Med · February 1, 2023 Rationale: There are limited therapeutic options for patients with coronavirus disease (COVID-19)-related acute respiratory distress syndrome with inflammation-mediated lung injury. Mesenchymal stromal cells offer promise as immunomodulatory agents. Object ... Full text Link to item Cite

Rationale and design of a randomized trial evaluating an external support device for saphenous vein coronary grafts.

Journal article Am Heart J · April 2022 BACKGROUND: Coronary artery bypass grafting (CABG) is the most common revascularization approach for the treatment of multi-vessel coronary artery disease. While the internal mammary artery is nearly universally used to bypass the left anterior descending ... Full text Link to item Cite

Renal function and coronary bypass surgery in patients with ischemic heart failure.

Journal article J Thorac Cardiovasc Surg · February 2022 OBJECTIVE: Chronic kidney disease is a known risk factor in cardiovascular disease, but its influence on treatment effect of bypass surgery remains unclear. We assessed the influence of chronic kidney disease on 10-year mortality and cardiovascular outcome ... Full text Link to item Cite

Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting in left main coronary artery disease: an individual patient data meta-analysis.

Journal article Lancet · December 18, 2021 BACKGROUND: The optimal revascularisation strategy for patients with left main coronary artery disease is uncertain. We therefore aimed to evaluate long-term outcomes for patients treated with percutaneous coronary intervention (PCI) with drug-eluting sten ... Full text Link to item Cite

Risk for non-home discharge following surgery for ischemic mitral valve disease.

Journal article J Thorac Cardiovasc Surg · December 2021 OBJECTIVES: To determine the frequency and risk factors for non-home discharge (NHD) and its association with clinical outcomes and quality of life (QOL) at 1 year following cardiac surgery in patients with ischemic mitral regurgitation (IMR). METHODS: Dis ... Full text Link to item Cite

Coronary Anastomosis Simulation: Directed Interventions to Optimize Success.

Journal article Ann Thorac Surg · June 2021 BACKGROUND: The role of simulation-based training in coronary artery bypass grafting remains undefined. Barriers to simulator use include clinical and personal obligations, insufficient materials, and lack of mentorship. The purpose of this study was to im ... Full text Link to item Cite

Invasive Mycobacterium abscessus Complex Infection After Cardiac Surgery: Epidemiology, Management, and Clinical Outcomes.

Journal article Clin Infect Dis · April 8, 2021 BACKGROUND: We recently mitigated a clonal outbreak of hospital-acquired Mycobacterium abscessus complex (MABC), which included a large cluster of adult patients who developed invasive infection after exposure to heater-cooler units during cardiac surgery. ... Full text Link to item Cite

Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral Regurgitation.

Journal article J Am Coll Cardiol · February 16, 2021 BACKGROUND: Whether to repair nonsevere tricuspid regurgitation (TR) during surgery for ischemic mitral valve regurgitation (IMR) remains uncertain. OBJECTIVES: The goal of this study was to investigate the incidence, predictors, and clinical significance ... Full text Open Access Link to item Cite

Cost-effectiveness of coronary artery bypass grafting plus mitral valve repair versus coronary artery bypass grafting alone for moderate ischemic mitral regurgitation.

Journal article J Thorac Cardiovasc Surg · June 2020 OBJECTIVE: The Cardiothoracic Surgical Trials Network reported that left ventricular reverse remodeling at 2 years did not differ between patients with moderate ischemic mitral regurgitation randomized to coronary artery bypass grafting plus mitral valve r ... Full text Link to item Cite

Association of postoperative complications and outcomes following coronary artery bypass grafting.

Journal article Am Heart J · April 2020 BACKGROUND: The long-term effects of postoperative complications following coronary artery bypass grafting (CABG) are unknown. METHODS: Medicare-linked records from the Society of Thoracic Surgeons Adult Cardiac Surgery Database were queried for isolated C ... Full text Link to item Cite

Impact of Aortic Atherosclerosis Burden on Outcomes of Surgical Aortic Valve Replacement.

Journal article Ann Thorac Surg · February 2020 BACKGROUND: Epiaortic ultrasound detects and localizes ascending aortic atherosclerosis. In this analysis we investigated the association between epiaortic ultrasound-based atheroma grade during surgical aortic valve replacement (SAVR) and perioperative ad ... Full text Link to item Cite

Impact of Microbiological Organism Type on Surgically Managed Endocarditis.

Journal article Ann Thorac Surg · November 2019 BACKGROUND: This study describes the impact of organism and valve type on surgically managed infective endocarditis (IE) from The Society of Thoracic Surgeons (STS) database. We developed a risk model for surgically managed endocarditis that includes the m ... Full text Link to item Cite

Relation of Postdischarge Care Fragmentation and Outcomes in Transcatheter Aortic Valve Implantation from the STS/ACC TVT Registry.

Journal article Am J Cardiol · September 15, 2019 Fragmented care following elective surgery has been associated with poor outcomes. The association between fragmented care and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. We examined patients who underwent TAV ... Full text Link to item Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal article Anesthesiology · June 2019 BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ... Full text Open Access Link to item Cite

Sex-Based Differences in Outcomes After Mitral Valve Surgery for Severe Ischemic Mitral Regurgitation: From the Cardiothoracic Surgical Trials Network.

Journal article JACC Heart Fail · June 2019 OBJECTIVES: This study investigated sex-based differences in outcomes after mitral valve (MV) surgery for severe ischemic mitral regurgitation (SIMR). BACKGROUND: Whether differences in outcomes exist between men and women after surgery for SIMR remains un ... Full text Link to item Cite

Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation.

Journal article J Am Coll Cardiol · May 21, 2019 BACKGROUND: The incidence of permanent pacemaker (PPM) implantation is higher following mitral valve surgery (MVS) with ablation for atrial fibrillation (AF) compared with MVS alone. OBJECTIVES: This study identified risk factors and outcomes associated wi ... Full text Link to item Cite

One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program.

Journal article J Thorac Cardiovasc Surg · May 2019 OBJECTIVE: Our enhanced recovery after cardiac surgery (ERAS Cardiac) program is an evidence-based interdisciplinary process, which has not previously been systematically applied to cardiac surgery in the United States. METHODS: The Knowledge-to-Action Fra ... Full text Link to item Cite

Biatrial maze procedure versus pulmonary vein isolation for atrial fibrillation during mitral valve surgery: New analytical approaches and end points.

Journal article J Thorac Cardiovasc Surg · January 2019 OBJECTIVE: To use novel statistical methods for analyzing the effect of lesion set on (long-standing) persistent atrial fibrillation (AF) in the Cardiothoracic Surgical Trials Network trial of surgical ablation during mitral valve surgery (MVS). METHODS: T ... Full text Link to item Cite

Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal article J Am Heart Assoc · December 4, 2018 Background In older adults undergoing cardiac surgery, prediction of downstream risk is critical. Our objective was to determine the association of 5-m gait speed with 1-year mortality and repeat hospitalization following cardiac surgery. Methods and Resul ... Full text Link to item Cite

Correction to: ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease.

Journal article J Nucl Cardiol · December 2018 To more clearly reflect the relationship between iFR (instantaneous wave-free ratio) and FFR (fractional flow reserve), this Correction document highlights the following changes to the original document published in the Journal of Nuclear Cardiology; the v ... Full text Link to item Cite

Cost-Effectiveness of Mitral Valve Repair Versus Replacement for Severe Ischemic Mitral Regurgitation: A Randomized Clinical Trial From the Cardiothoracic Surgical Trials Network.

Journal article Circ Cardiovasc Qual Outcomes · November 14, 2018 BACKGROUND: The CTSN (Cardiothoracic Surgical Trials Network) recently reported no difference in left ventricular end-systolic volume index or in survival at 2 years between patients with severe ischemic mitral regurgitation (MR) randomized to mitral valve ... Full text Link to item Cite

Robotic Mitral Valve Repair in Older Individuals: An Analysis of The Society of Thoracic Surgeons Database.

Journal article Ann Thorac Surg · November 2018 BACKGROUND: National outcomes of robotic mitral valve repair (rMVr) compared with sternotomy (sMVr) in older patients are currently unknown. METHODS: From 2011 to 2014, all patients aged 65 years and older undergoing MVr in The Society of Thoracic Surgeons ... Full text Open Access Link to item Cite

Society of Thoracic Surgeons Risk Score and EuroSCORE-2 Appropriately Assess 30-Day Postoperative Mortality in the STICH Trial and a Contemporary Cohort of Patients With Left Ventricular Dysfunction Undergoing Surgical Revascularization.

Journal article Circ Heart Fail · November 2018 BACKGROUND: The STICH trial (Surgical Treatment for Ischemic Heart Failure) demonstrated a survival benefit of coronary artery bypass grafting in patients with ischemic cardiomyopathy and left ventricular dysfunction. The Society of Thoracic Surgeons (STS) ... Full text Link to item Cite

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial.

Journal article Lancet · October 27, 2018 BACKGROUND: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine t ... Full text Link to item Cite

Dual antiplatelet therapy for perioperative myocardial infarction following CABG surgery.

Journal article Am Heart J · May 2018 OBJECTIVES: Perioperative myocardial infarction (MI) after coronary artery bypass graft surgery (CABG) has been associated with adverse outcome. Whether perioperative MI should be treated with dual antiplatelet therapy (DAPT) is unknown. We compared the ef ... Full text Link to item Cite

Secondary surgical-site infection after coronary artery bypass grafting: A multi-institutional prospective cohort study.

Journal article J Thorac Cardiovasc Surg · April 2018 OBJECTIVE: To analyze patient risk factors and processes of care associated with secondary surgical-site infection (SSI) after coronary artery bypass grafting (CABG). METHODS: Data were collected prospectively between February and October 2010 for consenti ... Full text Link to item Cite

18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery.

Journal article Anesthesiology · April 2018 BACKGROUND: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patie ... Full text Link to item Cite

Glycemic control in patients undergoing coronary artery bypass graft surgery: Clinical features, predictors, and outcomes.

Journal article J Crit Care · December 2017 PURPOSE: Critically ill patients with hyperglycemia have worse prognosis. The degree to which glycemic control is achieved following CABG surgery and the association with clinical outcomes is not well understood. MATERIALS AND METHODS: We studied patients ... Full text Link to item Cite

ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease : A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Thoracic Surgeons.

Journal article J Nucl Cardiol · October 2017 The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision ... Full text Link to item Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal article Anesth Analg · October 2017 BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ... Full text Open Access Link to item Cite

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease.

Journal article N Engl J Med · September 21, 2017 BACKGROUND: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS: We conducted a ... Full text Link to item Cite

Effect of Cerebral Embolic Protection Devices on CNS Infarction in Surgical Aortic Valve Replacement: A Randomized Clinical Trial.

Journal article JAMA · August 8, 2017 IMPORTANCE: Stroke is a major complication of surgical aortic valve replacement (SAVR). OBJECTIVE: To determine the efficacy and adverse effects of cerebral embolic protection devices in reducing ischemic central nervous system (CNS) injury during SAVR. DE ... Full text Link to item Cite

Revascularization Strategies and Outcomes in Elderly Patients With Multivessel Coronary Disease.

Journal article Ann Thorac Surg · July 2017 BACKGROUND: Balancing risks and benefits of revascularization in elderly patients with multivessel coronary artery disease (CAD) is challenging. The appropriate revascularization strategy for elderly patients with multivessel CAD is unclear. METHODS: We us ... Full text Link to item Cite

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients.

Journal article N Engl J Med · April 20, 2017 BACKGROUND: Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and reduces levels of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the efficacy of bococizumab in patients at ... Full text Link to item Cite

Two-Phase Hospital-Associated Outbreak of Mycobacterium abscessus: Investigation and Mitigation.

Journal article Clin Infect Dis · April 1, 2017 BACKGROUND: Nontuberculous mycobacteria (NTM) commonly colonize municipal water supplies and cause healthcare-associated outbreaks. We investigated a biphasic outbreak of Mycobacterium abscessus at a tertiary care hospital. METHODS: Case patients had recen ... Full text Link to item Cite

ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes : A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons.

Journal article J Nucl Cardiol · April 2017 The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision ... Full text Link to item Cite

ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons.

Journal article J Am Coll Cardiol · February 7, 2017 The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision ... Full text Link to item Cite

Relation of Post-Coronary Artery Bypass Graft Creatine Kinase-MB Elevations and New Q Waves With Long-Term Cardiovascular Death in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease.

Journal article Am J Cardiol · December 1, 2016 Associations of early creatine phosphokinase-MB (CK-MB) elevation and new Q waves and their association with cardiovascular death (CVD) after coronary artery bypass grafting (CABG) have been reported, but this association has not been studied in a large po ... Full text Link to item Cite

Impact of Left Ventricular to Mitral Valve Ring Mismatch on Recurrent Ischemic Mitral Regurgitation After Ring Annuloplasty.

Journal article Circulation · October 25, 2016 BACKGROUND: In ischemic mitral regurgitation (IMR), ring annuloplasty is associated with a significant rate of recurrent MR. Ring size is based on intertrigonal distance without consideration of left ventricular (LV) size. However, LV size is an important ... Full text Link to item Cite

Coronary-Artery Bypass Grafting.

Journal article N Engl J Med · September 8, 2016 Full text Link to item Cite

2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease, 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction, 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery.

Journal article Circulation · September 6, 2016 Full text Link to item Cite

Hybrid Coronary Revascularization for the Treatment of Multivessel Coronary Artery Disease: A Multicenter Observational Study.

Journal article J Am Coll Cardiol · July 26, 2016 BACKGROUND: Hybrid coronary revascularization (HCR) combines minimally invasive surgical coronary artery bypass grafting of the left anterior descending artery with percutaneous coronary intervention (PCI) of non-left anterior descending vessels. HCR is in ... Full text Link to item Cite

Indications, algorithms, and outcomes for coronary artery bypass surgery in patients with acute coronary syndromes.

Journal article Coron Artery Dis · June 2016 For patients with a non-ST-segment elevation acute coronary syndrome (NSTE-ACS), guideline recommendations and treatment pathways focus on revascularization for definitive treatment if the patient is an appropriate candidate. Despite the widespread use of ... Full text Link to item Cite

Gait Speed and Operative Mortality in Older Adults Following Cardiac Surgery.

Journal article JAMA Cardiol · June 1, 2016 IMPORTANCE: Prediction of operative risk is a critical step in decision making for cardiac surgery. Existing risk models may be improved by integrating a measure of frailty, such as 5-m gait speed, to better capture the heterogeneity of the older adult pop ... Full text Link to item Cite

Two-Year Outcomes of Surgical Treatment of Moderate Ischemic Mitral Regurgitation.

Journal article N Engl J Med · May 19, 2016 BACKGROUND: In a trial comparing coronary-artery bypass grafting (CABG) alone with CABG plus mitral-valve repair in patients with moderate ischemic mitral regurgitation, we found no significant difference in the left ventricular end-systolic volume index ( ... Full text Link to item Cite

Coronary-Artery Bypass Grafting.

Journal article N Engl J Med · May 19, 2016 Full text Link to item Cite

The utility of the aortic dissection team: outcomes and insights after a decade of experience.

Journal article Ann Cardiothorac Surg · May 2016 BACKGROUND: Mortality rates following acute type A aortic dissection (ATAAD) repair are reduced when operations are performed by a high-volume acute aortic dissection (AAD) team, leading to efforts to centralize ATAAD care. Here, we describe our experience ... Full text Link to item Cite

Clopidogrel use After Myocardial Revascularization: Prevalence, Predictors, and One-Year Survival Rate.

Journal article Braz J Cardiovasc Surg · April 2016 INTRODUCTION: Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. OBJECTIVE: Identify predictors of clopidogrel following CABG. METHODS: We evaluat ... Full text Open Access Link to item Cite

Two-Year Outcomes of Surgical Treatment of Severe Ischemic Mitral Regurgitation.

Journal article N Engl J Med · January 28, 2016 BACKGROUND: In a randomized trial comparing mitral-valve repair with mitral-valve replacement in patients with severe ischemic mitral regurgitation, we found no significant difference in the left ventricular end-systolic volume index (LVESVI), survival, or ... Full text Link to item Cite

Frequency and Predictors of Internal Mammary Artery Graft Failure and Subsequent Clinical Outcomes: Insights From the Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT) IV Trial.

Journal article Circulation · January 12, 2016 BACKGROUND: The internal mammary artery (IMA) is the preferred conduit for bypassing the left anterior descending (LAD) artery in patients undergoing coronary artery bypass grafting. Systematic evaluation of the frequency and predictors of IMA failure and ... Full text Link to item Cite

Genome-wide association study of acute kidney injury after coronary bypass graft surgery identifies susceptibility loci.

Journal article Kidney Int · October 2015 Acute kidney injury (AKI) is a common, serious complication of cardiac surgery. Since prior studies have supported a genetic basis for postoperative AKI, we conducted a genome-wide association study (GWAS) for AKI following coronary bypass graft (CABG) sur ... Full text Open Access Link to item Cite

Long-Term Survival After Bovine Pericardial Versus Porcine Stented Bioprosthetic Aortic Valve Replacement: Does Valve Choice Matter?

Journal article Ann Thorac Surg · August 2015 BACKGROUND: Bioprosthetic options are increasingly used for surgical aortic valve replacement (AVR). However, current decision making regarding bioprosthetic valve choice is not data-driven given incomplete information on comparative long-term outcomes aft ... Full text Link to item Cite

Genome-wide association study of perioperative myocardial infarction after coronary artery bypass surgery.

Journal article BMJ Open · May 6, 2015 OBJECTIVES: Identification of patient subpopulations susceptible to develop myocardial infarction (MI) or, conversely, those displaying either intrinsic cardioprotective phenotypes or highly responsive to protective interventions remain high-priority knowl ... Full text Open Access Link to item Cite

Repair or observe moderate ischemic mitral regurgitation during coronary artery bypass grafting? Prospective randomized multicenter data.

Journal article Ann Cardiothorac Surg · May 2015 Ischemic mitral regurgitation (MR) is a common occurrence following myocardial infarction and its presence is associated with poor outcomes. The optimal treatment of ischemic MR is a matter of debate, especially for patients with moderate MR severity. Some ... Full text Link to item Cite

Surgical Ablation of Atrial Fibrillation during Mitral-Valve Surgery.

Journal article N Engl J Med · March 16, 2015 Background Among patients undergoing mitral-valve surgery, 30 to 50% present with atrial fibrillation, which is associated with reduced survival and increased risk of stroke. Surgical ablation of atrial fibrillation has been widely adopted, but evidence re ... Full text Link to item Cite

Genetic variants associated with vein graft stenosis after coronary artery bypass grafting.

Journal article Heart Surg Forum · February 27, 2015 BACKGROUND: Vein graft stenosis after coronary artery bypass grafting (CABG) is common. Identifying genes associated with vein graft stenosis after CABG could reveal novel mechanisms of disease and discriminate patients at risk for graft failure. We hypoth ... Full text Link to item Cite

Predictors of long-term clinical endpoints in patients with refractory angina.

Journal article J Am Heart Assoc · January 30, 2015 BACKGROUND: Clinical outcomes in patients with refractory angina (RA) are poorly characterized and variably described. Using the Duke Database for Cardiovascular Disease (DDCD), we explored characteristics that drive clinical endpoints in patients with cla ... Full text Link to item Cite

The History of Duke Thoracic Surgery.

Journal article Semin Thorac Cardiovasc Surg · 2015 Since 1931, Duke Thoracic Surgery has been defined by excellence in patient care, research, and the education of leaders in surgery. In this work, the history, contributions, historic figures, and current structure of the program are reviewed. The program ... Full text Link to item Cite

Surgical treatment of moderate ischemic mitral regurgitation.

Journal article N Engl J Med · December 4, 2014 BACKGROUND: Ischemic mitral regurgitation is associated with increased mortality and morbidity. For surgical patients with moderate regurgitation, the benefits of adding mitral-valve repair to coronary-artery bypass grafting (CABG) are uncertain. METHODS: ... Full text Link to item Cite

Preprocedural ECG-gated computed tomography for prevention of complications during lead extraction.

Journal article Pacing Clin Electrophysiol · October 2014 BACKGROUND: Preprocedural multidetector computed tomography (MDCT) may identify patients at risk for mechanical complications during lead extraction. METHODS: To describe the use and feasibility of computed tomography scanning for preprocedural planning of ... Full text Link to item Cite

Quality-of-life outcomes with coronary artery bypass graft surgery in ischemic left ventricular dysfunction: a randomized trial.

Journal article Ann Intern Med · September 16, 2014 BACKGROUND: The STICH (Surgical Treatment for Ischemic Heart Failure) trial compared a strategy of routine coronary artery bypass grafting (CABG) with guideline-based medical therapy for patients with ischemic left ventricular dysfunction. OBJECTIVE: To de ... Full text Link to item Cite

Extent of coronary and myocardial disease and benefit from surgical revascularization in ischemic LV dysfunction [Corrected].

Journal article J Am Coll Cardiol · August 12, 2014 BACKGROUND: Patients with ischemic left ventricular dysfunction have higher operative risk with coronary artery bypass graft surgery (CABG). However, those whose early risk is surpassed by subsequent survival benefit have not been identified. OBJECTIVES: T ... Full text Link to item Cite

Management practices and major infections after cardiac surgery.

Journal article J Am Coll Cardiol · July 29, 2014 BACKGROUND: Infections are the most common noncardiac complication after cardiac surgery, but their incidence across a broad range of operations, as well as the management factors that shape infection risk, remain unknown. OBJECTIVES: This study sought to ... Full text Link to item Cite

Surgical revascularization is associated with maximal survival in patients with ischemic mitral regurgitation: a 20-year experience.

Journal article Circulation · June 17, 2014 BACKGROUND: The optimal treatment for ischemic mitral regurgitation remains actively debated. Our objective was to evaluate the relationship between ischemic mitral regurgitation treatment strategy and survival. METHODS AND RESULTS: We retrospectively revi ... Full text Link to item Cite

Analysis of geographic variations in the diagnosis and treatment of patients with aortic stenosis in North Carolina.

Journal article Am J Cardiol · June 1, 2014 Despite advances in the treatment of aortic stenosis (AS), many patients with AS remain untreated. Barriers to accessing cardiovascular surgical care may play a role in this undertreatment. We sought to examine whether there are geographic variations in th ... Full text Link to item Cite

Insurance status is associated with acuity of presentation and outcomes for thoracic aortic operations.

Journal article Circ Cardiovasc Qual Outcomes · May 2014 BACKGROUND: Nonelective procedure status is the greatest risk factor for postoperative morbidity and mortality in patients undergoing thoracic aortic operations. We hypothesized that uninsured patients were more likely to require nonelective thoracic aorti ... Full text Link to item Cite

Darapladib for preventing ischemic events in stable coronary heart disease.

Journal article N Engl J Med · May 1, 2014 BACKGROUND: Elevated lipoprotein-associated phospholipase A2 activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a select ... Full text Link to item Cite

A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry.

Journal article Europace · March 2014 AIMS: Given the advances in atrial fibrillation (AF) management and the availability of new European Society of Cardiology (ESC) guidelines, there is a need for the systematic collection of contemporary data regarding the management and treatment of AF in ... Full text Link to item Cite

Mitral-valve repair versus replacement for severe ischemic mitral regurgitation.

Journal article N Engl J Med · January 2, 2014 BACKGROUND: Ischemic mitral regurgitation is associated with a substantial risk of death. Practice guidelines recommend surgery for patients with a severe form of this condition but acknowledge that the supporting evidence for repair or replacement is limi ... Full text Link to item Cite

Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery.

Journal article Stroke · December 2013 BACKGROUND AND PURPOSE: Neurocognitive decline occurs frequently after cardiac surgery and persists in a significant number of patients. Magnesium is thought to provide neuroprotection by preservation of cellular energy metabolism, blockade of the N-methyl ... Full text Link to item Cite

Risk-adjusted survival after tissue versus mechanical aortic valve replacement: a 23-year assessment.

Journal article J Heart Valve Dis · November 2013 BACKGROUND AND AIM OF THE STUDY: Detailed analyses of risk-adjusted outcomes after mitral valve surgery have documented significant survival decrements with tissue valves at any age. Several recent studies of prosthetic aortic valve replacement (AVR) also ... Link to item Cite

Transfusion outcomes in patients undergoing coronary artery bypass grafting treated with prasugrel or clopidogrel: TRITON-TIMI 38 retrospective data analysis.

Journal article J Thorac Cardiovasc Surg · April 2013 OBJECTIVE: Coronary artery bypass grafting-related bleeding and associated transfusion is a concern with dual antiplatelet therapy in patients with acute coronary syndromes. The objective of the present study was to characterize a potential risk-adjusted d ... Full text Link to item Cite

Twenty-five-year outcomes after multiple internal thoracic artery bypass.

Journal article J Thorac Cardiovasc Surg · April 2013 OBJECTIVE: Coronary artery bypass grafting with multiple internal thoracic artery grafts is currently controversial. This study assessed single institutional outcomes with multiple internal thoracic artery grafting for guidance with future clinical decisio ... Full text Link to item Cite

Predictors of cognitive recovery after cardiac surgery.

Journal article Anesth Analg · February 2013 BACKGROUND: Postoperative neurocognitive decline occurs frequently. Although predictors of cognitive injury have been well examined, factors that modulate recovery have not. We sought to determine the predictors of cognitive recovery after initial injury f ... Full text Link to item Cite

Mitral valve repair for ischemic mitral regurgitation: review of current techniques.

Journal article Heart Lung Vessel · 2013 INTRODUCTION: Ischemic mitral regurgitation can be defined as moderate to severe mitral leak precipitated by acute myocardial infarction. Valve repair is now the procedure of choice, but some cases can pose difficult anatomy. This review will illustrate cu ... Link to item Cite

Effects of institutional volumes on operative outcomes for aortic root replacement in North America.

Journal article J Thorac Cardiovasc Surg · January 2013 OBJECTIVES: Hospital procedure volume has been strongly associated with postoperative mortality for a number of complex cardiovascular procedures. Although not yet described, a similar relationship might be expected for surgical procedures involving the ao ... Full text Link to item Cite

Preoperative anxiety as a predictor of mortality and major morbidity in patients aged >70 years undergoing cardiac surgery.

Journal article Am J Cardiol · January 1, 2013 The present study examined the association between patient-reported anxiety and postcardiac surgery mortality and major morbidity. Frailty Assessment Before Cardiac Surgery was a prospective multicenter cohort study of elderly patients undergoing cardiac s ... Full text Link to item Cite

Weighting composite endpoints in clinical trials: essential evidence for the heart team.

Journal article Ann Thorac Surg · December 2012 BACKGROUND: Coronary revascularization trials often use a composite endpoint of major adverse cardiac and cerebrovascular events (MACCE). The usual practice in analyzing data with a composite endpoint is to assign equal weights to each of the individual MA ... Full text Link to item Cite

Association between endoscopic vs open vein-graft harvesting and mortality, wound complications, and cardiovascular events in patients undergoing CABG surgery.

Journal article JAMA · August 1, 2012 CONTEXT: The safety and durability of endoscopic vein graft harvest in coronary artery bypass graft (CABG) surgery has recently been called into question. OBJECTIVE: To compare the long-term outcomes of endoscopic vs open vein-graft harvesting for Medicare ... Full text Link to item Cite

Mortality benefit with prasugrel in the TRITON-TIMI 38 coronary artery bypass grafting cohort: risk-adjusted retrospective data analysis.

Journal article J Am Coll Cardiol · July 31, 2012 OBJECTIVES: The objective of this study was to characterize the bleeding, transfusion, and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal before coronary artery bypass grafting (CABG). BACKGROUND: There is little ev ... Full text Link to item Cite

A phase 2 prospective, randomized, double-blind trial comparing the effects of tranexamic acid with ecallantide on blood loss from high-risk cardiac surgery with cardiopulmonary bypass (CONSERV-2 Trial).

Journal article J Thorac Cardiovasc Surg · May 2012 OBJECTIVE: Ecallantide is a recombinant peptide in the same class as aprotinin that inhibits plasma kallikrein, a major component of the contact coagulation and inflammatory cascades. Therefore, ecallantide was expected to reduce blood loss associated with ... Full text Link to item Cite

ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

Journal article J Thorac Cardiovasc Surg · April 2012 The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted ... Full text Link to item Cite

ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

Journal article J Am Coll Cardiol · February 28, 2012 The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted ... Full text Link to item Cite

Relationship between vein graft failure and subsequent clinical outcomes after coronary artery bypass surgery.

Journal article Circulation · February 14, 2012 BACKGROUND: Vein graft failure (VGF) is common after coronary artery bypass graft surgery, but its relationship with long-term clinical outcomes is unknown. In this retrospective analysis, we examined the relationship between VGF, assessed by coronary angi ... Full text Link to item Cite

Long-term survival of patients with ischemic cardiomyopathy treated by coronary artery bypass grafting versus medical therapy.

Journal article Ann Thorac Surg · February 2012 BACKGROUND: We prospectively applied the Surgical Treatment of Ischemic Cardiomyopathy trial entry criteria to an observational database to determine whether coronary artery bypass grafting (CABG) decreases mortality compared with medical therapy (MED) for ... Full text Link to item Cite

Design, rationale, and initiation of the Surgical Interventions for Moderate Ischemic Mitral Regurgitation Trial: a report from the Cardiothoracic Surgical Trials Network.

Journal article J Thorac Cardiovasc Surg · January 2012 OBJECTIVE: Patients with coronary artery disease complicated by moderate ischemic mitral regurgitation have demonstrably poorer outcome than do patients with coronary artery disease but without mitral regurgitation. The optimal treatment of this condition ... Full text Link to item Cite

2011 ACCF/AHA guideline for coronary artery bypass graft surgery: Executive summary

Journal article Journal of the American College of Cardiology · December 6, 2011 Full text Cite

Postoperative inotrope and vasopressor use following CABG: outcome data from the CAPS-care study.

Journal article J Card Surg · November 2011 BACKGROUND/AIM: Limited clinical data exist to guide practice patterns and evidence-based use of inotropes and vasopressors following coronary artery bypass grafting (CABG). METHODS: Contemporary Analysis of Perioperative Cardiovascular Surgical Care (CAPS ... Full text Link to item Cite

Thrombomodulin gene variants are associated with increased mortality after coronary artery bypass surgery in replicated analyses.

Journal article Circulation · September 13, 2011 BACKGROUND: We tested the hypothesis that genetic variation in thrombotic and inflammatory pathways is independently associated with long-term mortality after coronary artery bypass graft (CABG) surgery. METHODS AND RESULTS: Two separate cohorts of patient ... Full text Link to item Cite

Effects of C5 complement inhibitor pexelizumab on outcome in high-risk coronary artery bypass grafting: combined results from the PRIMO-CABG I and II trials.

Journal article J Thorac Cardiovasc Surg · July 2011 OBJECTIVE: The previous Pexelizumab for Reduction of Infarction and Mortality in Coronary Artery Bypass Graft Surgery I (PRIMO-CABG I) trial (n = 3099) indicated that C5 complement inhibition with pexelizumab might reduce myocardial infarction (MI) and pos ... Full text Link to item Cite

Increasing mitral valve repair rates with nonresectional techniques.

Journal article Innovations (Phila) · July 2011 In every common mitral pathology studied to date, repairing the patient's own diseased valve to adequate function has yielded superior long-term results as compared with prosthetic valve replacement with either tissue or mechanical devices. Thus, increasin ... Full text Link to item Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal article Ann Thorac Surg · June 2011 BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ... Full text Link to item Cite

Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest.

Journal article J Thorac Cardiovasc Surg · May 2011 OBJECTIVE: Massive perioperative blood product transfusion may be required with thoracic aortic operations and is associated with poor outcomes. We analyzed independent predictors of massive transfusion in thoracic aortic surgical patients undergoing deep ... Full text Link to item Cite

Association of myocardial enzyme elevation and survival following coronary artery bypass graft surgery.

Journal article JAMA · February 9, 2011 CONTEXT: Several small studies have suggested that cardiac enzyme elevation in the 24 hours following coronary artery bypass graft (CABG) surgery is associated with worse prognosis, but a definitive study is not available. Also, the long-term prognostic im ... Full text Link to item Cite

Outcomes for endocarditis surgery in North America: a simplified risk scoring system.

Journal article J Thorac Cardiovasc Surg · January 2011 OBJECTIVE: Operation for infective endocarditis is associated with the highest mortality of any valve disease, with overall rates of in-hospital mortality exceeding 20%. The Society of Thoracic Surgeons Adult Cardiac Surgery Database was examined to develo ... Full text Link to item Cite

The relationship of plasma transfusion from female and male donors with outcome after cardiac surgery.

Journal article J Thorac Cardiovasc Surg · December 2010 OBJECTIVE: Pulmonary dysfunction is common in transfused patients recovering from heart surgery. Plasma transfusion from female donors has been linked with rare catastrophic lung injury, but its relationship with outcome after cardiac surgery is poorly und ... Full text Link to item Cite

Richard E. Clark Award. Aortic dissection as a complication of cardiac surgery: report from the Society of Thoracic Surgeons database.

Journal article Ann Thorac Surg · December 2010 BACKGROUND: Aortic dissection as a complication of cardiac surgery is a rare but often lethal event. We sought to determine the frequency of this complication in the STS (Society of Thoracic Surgeons) database as well as the outcomes of patients who suffer ... Full text Link to item Cite

Influence of patient age on procedural selection in mitral valve surgery.

Journal article Ann Thorac Surg · November 2010 BACKGROUND: Previous studies suggest that mitral valve replacement is comparable to repair in the elderly, and a national trend exists toward tissue valves. However, few direct comparison data are available, and this study evaluated the effects of patient ... Full text Link to item Cite

Intraoperative systolic blood pressure variability predicts 30-day mortality in aortocoronary bypass surgery patients.

Journal article Anesthesiology · August 2010 BACKGROUND: Few data support an association between blood pressure variability and clinical outcomes during cardiac surgery. We tested the hypothesis that intraoperative systolic blood pressure variability outside a targeted blood pressure range predicts 3 ... Full text Link to item Cite

Association of the 98T ELAM-1 polymorphism with increased bleeding after cardiac surgery.

Journal article J Cardiothorac Vasc Anesth · June 2010 OBJECTIVE: Hemorrhage continues to be a major problem after cardiac surgery despite the routine use of antifibrinolytic drugs, with striking inter-patient variability poorly explained by already known risk factors. The authors tested the hypothesis that ge ... Full text Link to item Cite

Safety of selective serotonin reuptake inhibitor use prior to coronary artery bypass grafting.

Journal article Clin Cardiol · June 2010 BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have been shown to increase bleeding risks. This study examined the association of perioperative coronary artery bypass grafting (CABG) bleeding risks and SSRI use prior to CABG. HYPOTHESIS: SSRI ... Full text Link to item Cite

Glycosylated hemoglobin levels and outcome in non-diabetic cardiac surgery patients.

Journal article Can J Anaesth · June 2010 PURPOSE: In diabetics, elevated preoperative hemoglobin A1c (HbA1c) levels are associated with increased complication rates after cardiac surgery. While many non-diabetics also have elevated HbA1c, the relationship with outcome in these patients is not wel ... Full text Link to item Cite

Mitral valve repair for degenerative disease: a 20-year experience.

Journal article Ann Thorac Surg · December 2009 BACKGROUND: Recent advances in surgical technique allow repair of most mitral valves with degenerative disease. However, few long-term data exist to support the superiority of repair versus prosthetic valve replacement, and repair could be limited by late ... Full text Link to item Cite

Mitral gradients and frequency of recurrence of mitral regurgitation after ring annuloplasty for ischemic mitral regurgitation.

Journal article Ann Thorac Surg · October 2009 BACKGROUND: Undersized ring annuloplasty and surgical revascularization are commonly used to correct ischemic mitral regurgitation (MR), but published series have failed to demonstrate a benefit compared with revascularization alone. We hypothesized that s ... Full text Link to item Cite

Increasing healthcare resource utilization after coronary artery bypass graft surgery in the United States.

Journal article Circ Cardiovasc Qual Outcomes · July 2009 BACKGROUND: Despite declining lengths of stay, postdischarge healthcare resource utilization may be increasing because of shifts to nonacute care settings. Although changes in hospital stay after coronary artery bypass graft (CABG) surgery have been descri ... Full text Link to item Cite

Influence of body mass index on the efficacy of revascularization in patients with coronary artery disease.

Journal article J Thorac Cardiovasc Surg · June 2009 OBJECTIVE: We examined the effect of body mass index on the association between revascularization strategy and survival in patients with coronary artery disease. METHODS: Using the Duke Database for Cardiovascular Disease, we selected 22,877 patients who u ... Full text Link to item Cite

Laser-assisted extraction of pacemaker and defibrillator leads: the role of the cardiac surgeon.

Journal article Ann Thorac Surg · May 2009 BACKGROUND: The development of laser-assisted extraction techniques for chronically implanted pacemaker and defibrillator leads has reduced the need for open surgical removal. Reports of the mortality from laser-assisted extraction range from 1.9% to 3.4%. ... Full text Link to item Cite

ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

Journal article Circulation · March 10, 2009 The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted ... Full text Link to item Cite

Randomized, double-blinded, placebo controlled study of neuroprotection with lidocaine in cardiac surgery.

Journal article Stroke · March 2009 BACKGROUND AND PURPOSE: Cognitive decline after cardiac surgery remains common and diminishes patients' quality of life. Based on experimental and clinical evidence, this study assessed the potential of intravenously administered lidocaine to reduce postop ... Full text Link to item Cite

ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: a report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

Journal article J Am Coll Cardiol · February 10, 2009 The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted ... Full text Link to item Cite

Clopidogrel use and bleeding after coronary artery bypass graft surgery.

Journal article Am Heart J · November 2008 BACKGROUND: Short-term use of clopidogrel plus aspirin among patients with acute coronary syndrome reduces ischemic events, but concerns about coronary artery bypass graft (CABG) surgery-related bleeding limit its early use. METHODS: Using data from 4,794 ... Full text Link to item Cite

Survival prognosis and surgical management of ischemic mitral regurgitation.

Journal article Ann Thorac Surg · September 2008 BACKGROUND: Ischemic mitral regurgitation (IMR) has an adverse prognosis, but survival characteristics and management are controversial. This study reviewed a 20-year series of IMR patients managed with multiple approaches to assess and refine surgical str ... Full text Link to item Cite

Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose: results of the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) trial.

Journal article Diabetes Care · May 2008 OBJECTIVE: Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and re ... Full text Link to item Cite

Revascularization for unprotected left main stem coronary artery stenosis stenting or surgery.

Journal article J Am Coll Cardiol · March 4, 2008 For coronary artery disease with unprotected left main stem (LMS) stenosis, coronary artery bypass grafting (CABG) is traditionally regarded as the "standard of care" because of its well-documented and durable survival advantage. There is now an increasing ... Full text Link to item Cite

Clinical and angiographic correlates of short- and long-term mortality in patients undergoing coronary artery bypass grafting.

Journal article Am J Cardiol · November 15, 2007 Differences in the clinical and angiographic factors associated with short- and long-term outcomes in patients undergoing coronary artery bypass grafting (CABG) are less known. Accordingly, differences were examined in clinical and angiographic correlates ... Full text Link to item Cite

Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly.

Journal article Anesthesiology · October 2007 BACKGROUND: Strategies for neuroprotection including hypothermia and hemodilution have been routinely practiced since the inception of cardiopulmonary bypass. Yet postoperative neurocognitive deficits that diminish the quality of life of cardiac surgery pa ... Full text Link to item Cite

Myocardial infarction following coronary artery bypass graft surgery increases healthcare resource utilization.

Journal article Crit Care Med · May 2007 OBJECTIVE: To assess the health economic impact of perioperative myocardial infarction in a cohort of patients undergoing coronary artery bypass graft surgery. DESIGN: Retrospective cohort analysis using data from hospital bills and uniform billing forms. ... Full text Link to item Cite

Physician payment for 2007: a description of the process by which major changes in valuation of cardiothoracic surgical procedures occurred.

Journal article Ann Thorac Surg · January 2007 Throughout the last 3 years, the Society of Thoracic Surgeons (STS) has put forth a major effort towards more accurate valuation of the work performed by cardiothoracic surgeons. The culmination of these efforts was realized on November 1, 2006, when the C ... Full text Link to item Cite

Effect of ramipril on the incidence of diabetes.

Journal article N Engl J Med · October 12, 2006 BACKGROUND: Previous studies have suggested that blockade of the renin-angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension. METHODS: In a double-blind, randomized clinical trial with a 2-by-2 factorial design, we r ... Full text Link to item Cite

Selection of surgical or percutaneous coronary intervention provides differential longevity benefit.

Journal article Ann Thorac Surg · October 2006 BACKGROUND: Treatment of coronary artery disease (CAD) is evolving with better medications, improvements in percutaneous coronary intervention (PCI), and enhanced techniques for coronary artery bypass grafting (CABG). METHODS: In this study, 18,481 patient ... Full text Link to item Cite

Risk factors for 1-year mortality after postoperative mediastinitis.

Journal article J Thorac Cardiovasc Surg · September 2006 OBJECTIVE: Postoperative mediastinitis after median sternotomy is associated with disability and mortality. The aim of this study was to identify risk factors for mortality 1 year after postoperative mediastinitis diagnosis. METHODS: Postoperative mediasti ... Full text Link to item Cite

Effect of pexelizumab in coronary artery bypass graft surgery with extended aortic cross-clamp time.

Journal article Ann Thorac Surg · September 2006 BACKGROUND: Prolonged cross-clamp time during cardiac surgery increases the risk of postoperative mortality and myocardial injury. This subanalysis from the pexelizumab for reduction of infarction and mortality in coronary artery bypass grafting surgery (P ... Full text Link to item Cite

Impact of internal mammary artery conduit on long-term outcomes after percutaneous intervention of saphenous vein graft.

Journal article Circulation · July 4, 2006 BACKGROUND: The influence of an internal mammary artery (IMA) graft on long-term outcomes after percutaneous saphenous vein graft (SVG) intervention is currently unknown. METHODS AND RESULTS: To examine the impact of IMA on outcomes in patients undergoing ... Full text Link to item Cite

Prognosis of patients taking selective serotonin reuptake inhibitors before coronary artery bypass grafting.

Journal article Am J Cardiol · July 1, 2006 Depression is increasingly recognized as an independent prognostic risk factor in patients with coronary artery disease and coronary artery bypass grafting (CABG). The use of selective serotonin reuptake inhibitors (SSRIs) for depression in patients with c ... Full text Link to item Cite

Predicting and preventing adverse neurologic outcomes with cardiac surgery.

Journal article J Card Surg · 2006 Adverse neurologic outcomes after cardiac surgery can have devastating consequences, among them increased mortality risk and, among survivors, loss of independence and a diminished quality of life. They also represent a burden on the health-care system, re ... Full text Link to item Cite

Implantable left ventricular assist devices: new hope for patients with end-stage heart failure.

Journal article N C Med J · 2006 INTRODUCTION: Recently, the Food and Drug Administration approved implantable left ventricular assist devices (LVAD) as destination therapy (DT) for end-stage heart failure patients who are ineligible for cardiac transplantation. OBJECTIVE AND STUDY DESIGN ... Link to item Cite

Relation of early saphenous vein graft failure to outcomes following coronary artery bypass surgery.

Journal article Am J Cardiol · November 1, 2005 Up to 20% of saphenous vein grafts (SVGs) fail within 2 years of coronary artery bypass grafting (CABG). The long-term effects of early SVG failure on major clinical events remain undefined in contemporary patient populations. We sought to examine the rela ... Full text Link to item Cite

Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery.

Journal article Circulation · August 30, 2005 BACKGROUND: Surgeons have adopted off-pump coronary artery bypass grafting (OPCAB) in an effort to reduce the morbidity of surgical revascularization. However, long-term outcome of OPCAB compared with conventional coronary artery bypass grafting (CABG) rem ... Full text Link to item Cite

Impact of mitral valve regurgitation evaluated by intraoperative transesophageal echocardiography on long-term outcomes after coronary artery bypass grafting.

Journal article Circulation · August 30, 2005 BACKGROUND: It is unclear if mild or moderate mitral valve regurgitation (MR) should be repaired at the time of coronary artery bypass grafting (CABG). We sought to determine the long-term effect of uncorrected MR, measured by intraoperative transesophagea ... Full text Link to item Cite

Infectious complications after cardiac surgery: lack of association with fresh frozen plasma or platelet transfusions.

Journal article J Cardiothorac Vasc Anesth · August 2005 OBJECTIVE: The purpose of this study was to examine the effect of perioperative transfusion of platelets and fresh frozen plasma (FFP) on infection rates after cardiac surgery. DESIGN: Retrospective study comparing infection rates after cardiac surgery amo ... Full text Link to item Cite

Genetic factors contribute to bleeding after cardiac surgery.

Journal article J Thromb Haemost · June 2005 BACKGROUND: Postoperative bleeding remains a common, serious problem for cardiac surgery patients, with striking inter-patient variability poorly explained by clinical, procedural, and biological markers. OBJECTIVE: We tested the hypothesis that genetic po ... Full text Link to item Cite

The role of aprotinin in a blood-conservation program.

Journal article J Cardiothorac Vasc Anesth · August 2004 Full text Link to item Cite

Metoprolol and coronary artery bypass grafting surgery: does intraoperative metoprolol attenuate acute beta-adrenergic receptor desensitization during cardiac surgery?

Journal article Anesth Analg · May 2004 UNLABELLED: Cardiac surgery results in significant impairment of beta-adrenergic receptor (beta AR) function and is a cause of depressed myocardial function after surgery. We previously demonstrated that acute administration of beta AR blocker during cardi ... Full text Link to item Cite

Economic impact of drug-eluting stents on hospital systems: a disease-state model.

Journal article Am Heart J · March 2004 BACKGROUND: Drug-eluting intracoronary stents decrease restenosis and later revascularization. The US Department of Health and Human Services (HHS), recognizing the financial and clinical impact of this technology, recently proposed accelerated reimburseme ... Full text Link to item Cite

Cost analysis of aprotinin for coronary artery bypass patients: analysis of the randomized trials.

Journal article Ann Thorac Surg · February 2004 BACKGROUND: The full kallikrein-inhibiting dose of aprotinin has been shown to reduce blood loss, transfusion requirements, and the systemic inflammatory response associated with cardiopulmonary bypass graft surgery (CABG). A half-dose regimen, although ha ... Full text Link to item Cite

The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery.

Journal article Ann Thorac Surg · September 2003 BACKGROUND: Acute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hematocrit 22% to 24%) during cardiopulmonary ... Full text Link to item Cite

Cardiac surgery in nonagenarians and centenarians.

Journal article J Am Coll Surg · September 2003 BACKGROUND: Nonagenarians and centenarians are a rapidly growing segment of the population. No previous study has used a national database to compare outcomes in these patients to those of other groups undergoing cardiac surgical procedures. STUDY DESIGN: ... Full text Link to item Cite

Depression as a risk factor for mortality after coronary artery bypass surgery.

Journal article Lancet · August 23, 2003 BACKGROUND: Studies that have shown clinical depression to be a risk factor for cardiac events after coronary artery bypass graft (CABG) surgery have had small sample sizes, short follow-up, and have not had adequate power to assess mortality. We sought to ... Full text Link to item Cite

Staphylococcus aureus bacteremia after median sternotomy: clinical utility of blood culture results in the identification of postoperative mediastinitis.

Journal article Circulation · July 8, 2003 BACKGROUND: Mediastinitis is a complication of coronary artery bypass graft surgery (CABG) that can be difficult to diagnose. This study evaluated the utility of blood culture results in identifying patients with mediastinitis. METHODS AND RESULTS: All uni ... Full text Link to item Cite

Low serum magnesium level predicts major adverse cardiac events after coronary artery bypass graft surgery.

Journal article Am Heart J · June 2003 BACKGROUND: Despite improved myocardial protection strategies and enhanced surgical techniques, mortality after coronary artery bypass graft surgery (CABG) remains essentially unchanged. This may be because of the increasing age of patients who undergo pri ... Full text Link to item Cite

Postcardiac surgery complications: association of acute renal dysfunction and atrial fibrillation.

Journal article Anesth Analg · March 2003 Featured Publication UNLABELLED: Postoperative creatinine increase is associated with adverse outcome after cardiac surgery. Although postoperative stroke and renal dysfunction are associated after cardiac surgery, suggesting a common systemic insult, a similar assessment of a ... Full text Link to item Cite

Risk of anaphylaxis from aprotinin re-exposure during LVAD removal and heart transplantation.

Journal article J Heart Lung Transplant · October 2002 Featured Publication Aprotinin has been shown to reduce transfusion requirements in re-operative cardiac surgery and in implantation of long-term left ventricular assist devices (LVAD). However, it is an antigenic polypeptide and re-exposure is associated with a small incidenc ... Full text Link to item Cite

Basic fibroblast growth factor is upregulated in hibernating myocardium.

Journal article J Surg Res · September 2002 Featured Publication BACKGROUND: Ischemia is known to be a potent stimulus for the upregulation of angiogenic growth factors, such as basic fibroblast growth factor (bFGF). While previous investigations have shown that many angiogenic growth factors are upregulated in animal m ... Full text Link to item Cite

Comparison of coronary artery bypass grafting versus medical therapy on long-term outcome in patients with ischemic cardiomyopathy (a 25-year experience from the Duke Cardiovascular Disease Databank).

Journal article Am J Cardiol · July 15, 2002 Featured Publication In this observational treatment comparison in a single center over 25 years, we sought to assess long-term outcomes of coronary artery bypass surgery (CABG) or medical therapy in patients with heart failure, coronary artery disease, and left ventricular sy ... Full text Link to item Cite

Neuroprotection is associated with beta-adrenergic receptor antagonists during cardiac surgery: evidence from 2,575 patients.

Journal article J Cardiothorac Vasc Anesth · June 2002 Featured Publication OBJECTIVE: To determine the impact of perioperative beta-adrenergic receptor (betaAR) antagonist administration on neurologic complications. DESIGN: Observational database analysis. SETTING: A clinical investigation at a single tertiary academic medical ce ... Full text Link to item Cite

The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass.

Journal article Anesth Analg · May 2002 Featured Publication UNLABELLED: Outcome after cardiac surgery varies depending on complication type. We therefore sought to determine the association between complication type, mortality, and length of stay in a large series of patients undergoing cardiac surgery with cardiop ... Full text Link to item Cite

Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery.

Journal article Stroke · February 2002 Featured Publication BACKGROUND AND PURPOSE: Temperature is a well-known modulator of experimental cerebral injury. We hypothesized that hyperthermia would be associated with a worsened cognitive outcome after coronary artery bypass graft surgery (CABG). METHODS: Three hundred ... Full text Link to item Cite

Association of leukocyte-depleted blood transfusions with infectious complications after cardiac surgery.

Journal article Surg Infect (Larchmt) · 2002 Featured Publication BACKGROUND: To test the hypothesis that leukocyte-mediated immunosuppression may contribute to postoperative infections after blood transfusions, we compared the incidence of postoperative infections in patients undergoing elective coronary artery bypass g ... Full text Link to item Cite

Report of a substudy on warm versus cold cardiopulmonary bypass: changes in creatinine clearance.

Journal article Ann Thorac Surg · November 2001 Featured Publication BACKGROUND: Renal dysfunction remains a major complication of cardiac operations. There is concern regarding the possibility of increased renal injury during warm cardiopulmonary bypass (CPB). Therefore, we tested the hypothesis that warm CPB is associated ... Full text Link to item Cite

Prospective randomized trial of normothermic versus hypothermic cardiopulmonary bypass on cognitive function after coronary artery bypass graft surgery.

Journal article Anesthesiology · November 2001 Featured Publication BACKGROUND: Despite significant advances in cardiopulmonary bypass (CPB) technology, surgical techniques, and anesthetic management, central nervous system complications occur in a large percentage of patients undergoing surgery requiring CPB. Many centers ... Full text Link to item Cite

The "ideal" replacement heart valve.

Journal article Am Heart J · May 2001 Featured Publication Full text Link to item Cite

Depressive symptoms and outcome of coronary artery bypass grafting.

Journal article Am J Crit Care · January 2001 Featured Publication BACKGROUND: Depressive symptoms are an independent risk factor for outcome in patients with cardiac disease, but their effect on outcome among patients undergoing coronary artery bypass grafting is not well understood. OBJECTIVES: To determine whether or n ... Link to item Cite

Current status of cardiac surgery in the abciximab-treated patient.

Journal article Ann Thorac Surg · August 2000 BACKGROUND: Early surgical experience with abciximab and other glycoprotein (GP) IIb/IIIa receptor antagonists suggested a tendency toward excessive bleeding in patients treated with these agents. With increased use of GP IIb/IIIa inhibitors, cardiac surge ... Full text Link to item Cite

Abciximab and bleeding during coronary surgery: results from the EPILOG and EPISTENT trials. Improve Long-term Outcome with abciximab GP IIb/IIIa blockade. Evaluation of Platelet IIb/IIIa Inhibition in STENTing.

Journal article Ann Thorac Surg · August 2000 BACKGROUND: Abciximab during percutaneous coronary revascularization reduces ischemic complications, but concern exists regarding increased bleeding risk should emergency coronary surgical procedures be required. METHODS: Outcomes were assessed among 85 pa ... Full text Link to item Cite

Intraoperative physiologic variables and outcome in cardiac surgery: Part I. In-hospital mortality.

Journal article Ann Thorac Surg · April 2000 BACKGROUND: Risk stratification schemes have been developed to predict outcome of coronary artery bypass grafting (CABG) procedures, which are predominately based upon unalterable preoperative patient characteristics. The purpose of this study was to deter ... Full text Link to item Cite

Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome.

Journal article Ann Thorac Surg · April 2000 BACKGROUND: The impact of alterable physiologic variables on neurologic outcome after coronary artery bypass grafting procedures is unknown. The purpose of this study was to determine whether minimum intraoperative hematocrit, maximum glucose concentration ... Full text Link to item Cite

Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network.

Journal article J Am Coll Cardiol · March 1, 2000 OBJECTIVES: The purpose of this study was to evaluate characteristics and outcomes of patients age > or =80 undergoing cardiac surgery. BACKGROUND: Prior single-institution series have found high mortality rates in octogenarians after cardiac surgery. Howe ... Full text Link to item Cite

Endoscopic versus open saphenous vein harvest: the effect on postoperative outcomes.

Journal article Ann Thorac Surg · December 1999 BACKGROUND: Endoscopic vein harvest (EVH) has been promoted as a possible solution to the wound complications, incisional pain, and prolonged convalesce associated with open vein harvesting (OVH). The purpose of this study was to objectively compare the tw ... Full text Link to item Cite

Comparison of direct aortic and femoral cannulation for port-access cardiac operations.

Journal article Ann Thorac Surg · October 1999 BACKGROUND: Differences in outcome after direct aortic cannulation (AORT) in the chest versus standard femoral arterial cannulation (FEM) have not been defined for minimally invasive cardiac operations utilizing the port-access approach. METHODS: A retrosp ... Full text Link to item Cite

Infant cardiopulmonary bypass: a procoagulant state.

Journal article Ann Thorac Surg · August 1999 BACKGROUND: Procoagulant activity after cardiopulmonary bypass (CPB) in infants may predispose to thrombotic and bleeding complications. The induction of tissue factor and prothrombinase activity on endothelial cell membranes is a primary step in the activ ... Full text Link to item Cite

Persistent left superior vena cava and partial anomalous pulmonary venous connection: incidental diagnosis by transesophageal echocardiography during coronary artery bypass surgery.

Journal article J Am Soc Echocardiogr · August 1999 Transesophageal echocardiography plays an important role in the intraoperative treatment of the heart surgery patient. Its utility in the description of both known and unexpected cardiac pathology is well established. We describe a patient with a previousl ... Full text Link to item Cite

Optimizing liquid ventilation as a lung protection strategy for neonatal cardiopulmonary bypass: full functional residual capacity dosing is more effective than half functional residual capacity dosing.

Journal article Crit Care Med · June 1999 OBJECTIVE: To evaluate and compare the protective effects of two different perflubron doses on hemodynamics and lung function in a neonatal animal model of cardiopulmonary bypass-induced lung injury. DESIGN: Prospective, randomized, controlled study. SETTI ... Full text Link to item Cite

Epsilon-aminocaproic acid administration and stroke following coronary artery bypass graft surgery.

Journal article Ann Thorac Surg · May 1999 BACKGROUND: Epsilon-aminocaproic acid is routinely used to reduce bleeding during cardiac surgery. Anecdotal reports of thrombotic complications have led to speculation regarding this drug's safety. We investigated the association between epsilon-aminocapr ... Full text Link to item Cite

Comparison of omental and pectoralis flaps for poststernotomy mediastinitis.

Journal article Ann Thorac Surg · February 1999 BACKGROUND: Pectoralis flaps are frequently used to treat poststernotomy mediastinitis. We compared the outcomes of omental transfer, an alternative treatment for mediastinitis, with those of pectoralis flaps. METHODS: Patients treated for poststernotomy m ... Full text Link to item Cite

Determinants of 15-year outcome with 1,119 standard Carpentier-Edwards porcine valves.

Journal article Ann Thorac Surg · December 1998 BACKGROUND: The determinants of long-term outcome 15 years or more after porcine valve replacement are poorly documented. METHODS: A retrospective review was performed of patients undergoing valve replacement with standard Carpentier-Edwards aortic (n = 53 ... Full text Link to item Cite

Mitral valve operation via Port Access versus median sternotomy.

Journal article Eur J Cardiothorac Surg · October 1998 OBJECTIVE: The advantages and disadvantages of minimally invasive Port Access mitral valve operation have not been defined relative to standard median sternotomy. A study was therefore designed to delineate differences in outcome from mitral operation via ... Full text Link to item Cite

Increasing tidal volumes and pulmonary overdistention adversely affect pulmonary vascular mechanics and cardiac output in a pediatric swine model.

Journal article Crit Care Med · April 1998 OBJECTIVES: In a pediatric swine model, the effects of increasing tidal volumes and the subsequent development of pulmonary overdistention on cardiopulmonary interactions were studied. The objective was to test the hypothesis that increasing tidal volumes ... Full text Link to item Cite

Liquid ventilation improves pulmonary function and cardiac output in a neonatal swine model of cardiopulmonary bypass.

Journal article J Thorac Cardiovasc Surg · March 1998 OBJECTIVE: Neonatal and infant cardiopulmonary bypass results in multiorgan system dysfunction. Organ protective strategies have traditionally been directed at the myocardium and brain while neglecting the sometimes severe injury to the lungs. We hypothesi ... Full text Link to item Cite

Cost-benefit and efficacy of aprotinin compared with epsilon-aminocaproic acid in patients having repeated cardiac operations: a randomized, blinded clinical trial.

Journal article Anesthesiology · December 1997 BACKGROUND: Aprotinin and epsilon-aminocaproic acid are routinely used to reduce bleeding during cardiac surgery. The marked difference in average wholesale cost between these two drug therapies (aprotinin, $1,080 vs. epsilon-aminocaproic acid, $11) has ge ... Full text Link to item Cite

Risk stratification for adverse economic outcomes in cardiac surgery.

Journal article Ann Thorac Surg · December 1997 BACKGROUND: Recent emphasis on cost-containment in the health-care environment has focused attention on the cost of medical procedures. Selection of the appropriate treatment for coronary artery disease is of increasing concern. Coronary artery bypass graf ... Full text Link to item Cite

Relationship between diabetes mellitus and long-term survival after coronary bypass and angioplasty.

Journal article Circulation · October 21, 1997 BACKGROUND: Recent subgroup analyses of randomized trials have suggested that percutaneous intervention in diabetic patients with multivessel disease results in higher mortality than coronary artery bypass graft surgery (CABG). We studied the relationship ... Full text Link to item Cite

Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: selective vasodilation of small pulmonary vessels during hypoxic pulmonary vasoconstriction.

Journal article J Thorac Cardiovasc Surg · June 1997 OBJECTIVE: In the setting of acute pulmonary artery hypertension, techniques to reduce right ventricular energy requirements may ameliorate cardiac failure and reduce morbidity and mortality. Inhaled nitric oxide, a selective pulmonary vasodilator, may be ... Full text Link to item Cite

Relationship of preoperative antiendotoxin core antibodies and adverse outcomes following cardiac surgery.

Journal article JAMA · February 26, 1997 OBJECTIVE: To test the hypothesis that low serum antiendotoxin core antibody (EndoCAb) level is an independent predictor of adverse outcome following cardiac surgery. DESIGN: Prospective, blinded, cohort study. SETTING: Tertiary care medical center. SUBJEC ... Link to item Cite

Measurement of vascular input impedance in infrainguinal vein grafts.

Journal article Ann Vasc Surg · January 1997 The purpose of this investigation was to measure vascular input impedance in infrainguinal vein grafts and assess the importance of clinical and hemodynamic parameters in predicting graft patency. Fifty-seven patients undergoing infrainguinal vein bypass g ... Full text Link to item Cite

Contrast echocardiography: influence of ultrasonic machine settings, mixing conditions, and pressurization on pixel intensity and microsphere size of Albunex solutions in vitro.

Journal article J Am Soc Echocardiogr · 1997 To use Albunex as a blood-flow tracer, the stability and consistency of microspheres under mixing conditions must be known. This study examined the effects of mixing conditions and machine settings on the size and echogenicity of Albunex solutions in vitro ... Full text Link to item Cite

Nitric oxide improves transpulmonary vascular mechanics but does not change intrinsic right ventricular contractility in an acute respiratory distress syndrome model with permissive hypercapnia.

Journal article Crit Care Med · September 1996 OBJECTIVE: To test the hypothesis that in a swine model of acute respiratory distress syndrome (ARDS) with permissive hypercapnia, inhaled nitric oxide would improve transpulmonary vascular mechanics and right ventricular workload while not changing intrin ... Full text Link to item Cite

Sternal plating for the treatment of sternal nonunion.

Journal article Ann Thorac Surg · August 1996 BACKGROUND: Sternal nonunion, defined as sternal pain with clicking, instability, or both for more than 6 months in the absence of infection, is an uncommon complication of median sternotomy. Nonunion is frequently complicated by the presence of multiple t ... Link to item Cite

Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease.

Journal article J Thorac Cardiovasc Surg · May 1996 The purpose of this study was to evaluate long-term survival benefits of bypass surgery and angioplasty versus medical therapy in 9263 patients at Duke University Medical Center between 1984 and 1990 with coronary artery disease confirmed by cardiac cathet ... Full text Link to item Cite

Effects of pulsatile perfusion on human saphenous vein vasoreactivity: a preliminary report.

Journal article Cardiovasc Surg · April 1996 This study examined the effects of exposure to arterial blood pressure and flow on human saphenous vein catecholamine sensitivity. Unused portions of saphenous vein from eight patients undergoing peripheral bypass procedures were mounted parallel in a spec ... Full text Link to item Cite

Input Impedance of Revascularized Skeletal Muscle, Renal, and Mesenteric Vascular Beds

Journal article Vascular and Endovascular Surgery · January 1, 1996 Input impedance describes the relationship between pressure and flow in a vascular system and, hence, characterizes the outflow bed. The purpose of this investigation was to measure input impedance spectra in vascular reconstructions of skeletal muscle, re ... Full text Cite

A multicenter, double-blind, placebo-controlled trial of aprotinin for reducing blood loss and the requirement for donor-blood transfusion in patients undergoing repeat coronary artery bypass grafting.

Journal article Circulation · October 15, 1995 BACKGROUND: Aprotinin is a serine protease inhibitor that reduces blood loss and transfusion requirements when administered prophylactically to cardiac surgical patients. To examine the safety and dose-related efficacy of aprotinin, a prospective, multicen ... Full text Link to item Cite

In acute lung injury, inhaled nitric oxide improves ventilation-perfusion matching, pulmonary vascular mechanics, and transpulmonary vascular efficiency.

Journal article J Thorac Cardiovasc Surg · September 1995 Acute respiratory distress syndrome continues to be associated with significant morbidity and mortality related to ventilation-perfusion mismatch, pulmonary hypertension, and right ventricular failure. It has been suggested that inhaled nitric oxide, which ... Full text Link to item Cite

Load-independent analysis of a pulsatile right ventricular assist device.

Journal article J Heart Lung Transplant · 1995 BACKGROUND: Right ventricular assist devices are becoming increasingly used as both a bridge to heart transplantation and as a means of temporary support after cardiopulmonary bypass. There has also been a resurgence of interest in pulsatile devices fueled ... Link to item Cite

Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery.

Journal article Circulation · November 1994 BACKGROUND: Procedure-related costs are of increasing concern in selecting the appropriate procedure for the treatment of coronary artery disease (CAD). METHODS AND RESULTS: To determine what preoperative factors influence total postoperative hospital cost ... Link to item Cite

Continuing evolution of therapy for coronary artery disease. Initial results from the era of coronary angioplasty.

Journal article Circulation · May 1994 BACKGROUND: Survival after coronary artery bypass graft surgery (CABG) and medical therapy in patients with coronary artery disease (CAD) has been studied in both randomized trials and observational treatment comparisons. Over the past decade, the use of c ... Full text Link to item Cite

Finite-element analysis of ventricular ejection

Journal article Circulation · 1994 Cite

Right thoracotomy for reoperative right coronary artery bypass procedures.

Journal article Ann Thorac Surg · January 1994 The use of a right thoracotomy is a safe alternative approach for reentering the mediastinum for reoperative right coronary artery bypass grafting. This technique was used in 9 patients and allowed minimal dissection, reducing the risks of hemorrhage and i ... Full text Link to item Cite

A prospective trial of subxiphoid pericardiotomy in the diagnosis and treatment of large pericardial effusion. A follow-up report.

Journal article Ann Surg · December 1993 OBJECTIVE: This study was designed to determine the cause of large pericardial effusions and evaluate the efficacy of subxiphoid pericardiotomy. SUMMARY BACKGROUND DATA: Despite great advances in the techniques used to diagnose pericardial effusions, much ... Full text Link to item Cite

Coronary artery bypass in patients with severely depressed ventricular function.

Journal article Ann Thorac Surg · September 1993 This study evaluates whether patients with coronary artery disease and severely depressed left ventricular ejection fraction benefit from coronary artery bypass grafting. From 1981 to 1991, 118 consecutive patients with ejection fraction less than or equal ... Full text Link to item Cite

Pulmonary hemodynamic consequences of ECG-synchronized ventilation.

Journal article J Surg Res · August 1993 The pulmonary hemodynamic consequences of ECG-synchronized jet ventilation were studied in an acute closed chest swine model (n = 11). Eight jet timing protocols were compared to conventional mechanical ventilation. Hearts were paced atrially at 120 beats ... Full text Link to item Cite

1985: left thoracotomy for reoperative coronary artery bypass procedures. 1993 update.

Journal article Ann Thorac Surg · May 1993 This paper describes our experience in performing saphenous vein bypass grafts to the circumflex coronary artery system with a left thoracotomy in 9 patients. Illustrative case reports demonstrate the spectrum of patients for whom this approach has been us ... Full text Link to item Cite

The effects of local ventricular pacing on recovery from regional myocardial ischemia.

Journal article J Surg Res · April 1993 After surgical revascularization of ischemic myocardium, temporary ventricular pacing is often used, yet no data exist to indicate whether pacing ischemic versus nonischemic myocardium affects myocardial recovery. Therefore, chronically instrumented consci ... Full text Link to item Cite

The efficiency of pulmonary blood transport following single lung transplantation.

Journal article J Surg Res · April 1993 Perioperative right ventricular (RV) dysfunction remains a significant problem following single lung transplantation (SLT), especially in patients with pulmonary hypertension. Total RV power (Wt), a determinant of RV function, is the sum of the mean compon ... Full text Link to item Cite

Computer-assisted modeling of blood-flow: theoretical evidence for the existence of optimal flow wave patterns.

Journal article Comput Biol Med · March 1993 The purpose of this study was to model blood-flow waveforms in order to examine the relationship between various waveform shapes and input impedance spectra. Twenty distinct single cardiac cycle flow waveforms having the same mean flow and heart rate were ... Full text Link to item Cite

Right ventricular systolic performance in a porcine model

Journal article Journal of the American College of Cardiology · 1993 Cite

Pulmonary arterial impedance after single lung transplantation.

Journal article J Surg Res · May 1992 Single lung transplantation (SLT) is emerging as definitive therapy for end-stage pulmonary disease of varying etiology, yet a complete description of the hemodynamic properties of the transplanted lung has not been reported. In this study, Fourier analysi ... Full text Link to item Cite

Comparison of left and right ventricular compliances

Journal article Circulation · 1992 Cite

Comparison of left and right ventricular compliances

Journal article Circulation · 1992 Cite

First successful bridge to cardiac transplantation using direct mechanical ventricular actuation.

Journal article Ann Thorac Surg · December 1991 Currently available ventricular assist devices are technically difficult to implant, require continuous anticoagulation, and are associated with hemorrhagic and thromboembolic complications. Direct mechanical ventricular actuation is a biventricular assist ... Full text Link to item Cite

Action potential stimulation and recording with a portable microcomputer

Journal article Proceedings of the Annual Conference on Engineering in Medicine and Biology · December 1, 1991 A microcomputer-based data acquisition system was developed to provide electrocardiographic monitoring, nerve stimulation, and nerve and muscle response recording abilities for use in investigations of phrenic nerve dysfunction in animal models. The system ... Cite

An improved apparatus for in vitro study of mitral valve dynamics

Journal article Proceedings of the Annual Conference on Engineering in Medicine and Biology · December 1, 1991 A model left ventricle was developed for the study of mitral valve fluid and mechanical dynamics. Freshly excised human and animal mitral valves were mounted in the apparatus and subjected to conditions simulating cardiac disease states. Control was obtain ... Cite

Safety and efficacy of sonicated albumin microspheres in perfusion and vein graft patency assessments.

Journal article Clin Cardiol · November 1991 This study was designed to identify a concentration of sonicated albumin microspheres that is safe, useful in determining graft patency, and provides an estimate of regional myocardial perfusion. The study included 8 patients between 50 and 72 years of age ... Full text Link to item Cite

Quantitation of vascular outflow by measurement of impedance.

Journal article J Vasc Surg · September 1991 One of the most important determinants of graft patency is the degree and character of vascular outflow. This study was designed to evaluate input impedance as a functional assessment of the outflow bed of vascular grafts. Four distinct outflow environment ... Link to item Cite

Effects of internal mammary artery dissection on phrenic nerve perfusion and function.

Journal article Ann Thorac Surg · August 1991 The effects of left internal mammary artery (LIMA) dissection and distal division on phrenic nerve perfusion and function were examined in an adult swine model. Phrenic nerve perfusion was determined by left atrial injection of radioactively labeled micros ... Full text Link to item Cite

Ventricular perforation with valvoplasty.

Journal article Ann Thorac Surg · June 1991 Full text Link to item Cite

The surgical treatment of atrial fibrillation. II. Intraoperative electrophysiologic mapping and description of the electrophysiologic basis of atrial flutter and atrial fibrillation.

Journal article J Thorac Cardiovasc Surg · March 1991 Computerized mapping of atrial fibrillation was performed in animals and man. To study atrial fibrillation in a systematic manner, we developed a clinically relevant experimental model of atrial fibrillation. Chronic mitral regurgitation was created surgic ... Link to item Cite

Intraoperative management of severe endobronchial hemorrhage.

Journal article Ann Thorac Surg · February 1991 Endobronchial hemorrhage due to pulmonary artery perforation by a Swan-Ganz catheter developed during coronary artery bypass grafting while weaning from cardiopulmonary bypass. After reinstitution of cardio-pulmonary bypass with pulmonary artery venting, b ... Full text Link to item Cite

Determination of vascular input impedance in near real-time using a portable microcomputer

Journal article undefined · December 1, 1990 A method for determining vascular input impedance using a portable laptop computer coupled to more conventional laboratory measurement equipment is described. The major impediment overcome in the clinical implementation of this microcomputer-based system w ... Cite

Near real time vascular input impedance using a portable microcomputer

Journal article Proceedings of the Annual Conference on Engineering in Medicine and Biology · December 1, 1990 A microcomputer-based data acquisition and analysis system was developed to measure the hydraulic input impedance of the pulmonary vasculature in human and animal models. This system is capable of analyzing every fourth cardiac cycle. The system incorporat ... Cite

Functional consequences of the right ventricular isolation procedure.

Journal article J Thorac Cardiovasc Surg · October 1990 The right ventricular free wall was surgically isolated from the remainder of the heart in eight dogs to evaluate the functional consequences of this procedure. Each dog was instrumented with ultrasonic dimension transducers in the right and left ventricul ... Link to item Cite

Cryosurgical denervation of the heart: acute and chronic effects.

Journal article J Thorac Cardiovasc Surg · August 1990 A newly developed procedure for total cardiac denervation employing cryosurgical techniques is described. Thirty-three dogs underwent cryosurgical cardiac denervation. Twenty-seven survived the procedure and were divided into three groups. Completeness of ... Link to item Cite

Intraoperative perfusion contrast echocardiography. Initial experience during coronary artery bypass grafting.

Journal article J Thorac Cardiovasc Surg · March 1990 Intraoperative evaluation of the effectiveness of myocardial revascularization has been limited by an inability to assess regional myocardial perfusion. Microbubbles of sonicated diatrizoate sodium and diatrizoate meglumine (Renografin) have been an effect ... Link to item Cite

Effect of the right ventricular isolation procedure on ventricular vulnerability to fibrillation.

Journal article J Am Coll Cardiol · March 1, 1990 A certain critical mass of myocardium is believed to be necessary to initiate ventricular fibrillation. The right ventricular isolation procedure, employed clinically to confine ventricular tachyarrhythmias to the right ventricle, decreases the ventricular ... Full text Link to item Cite

Cocaine-mediated impairment of cardiac conduction in the dog: a potential mechanism for sudden death after cocaine.

Journal article J Pharmacol Exp Ther · January 1990 Deaths from cocaine abuse continue to increase, while the mechanism of lethality remains unclear. Previous investigations have focused on potential ventricular dysrhythmias and myocardial ischemic events from enhanced autonomic tone or seizure activity fro ... Link to item Cite

IAIMS - The role of strategic planning

Journal article Proceedings Annual Symposium on Computer Applications in Medical Care · December 1, 1989 In 1986, the Medical Center Information Systems Advisory Committee (MCISAC) was established as a standing committee of the Duke University Medical Center (DUMC) with responsibility for ongoing information policy formation and strategic planning. MCISAC's p ... Cite

Local and distant components of bipolar cardiac electrograms

Journal article Annual International Conference of the IEEE Engineering in Medicine and Biology Proceedings · November 1, 1989 Bipolar electrograms recorded during activation of the left or right ventricle alone exhibited deflections representing local or distant cardiac electrical activity. Local activation deflections had larger slope magnitudes and peak-to-peak amplitudes than ... Cite

Surgery for atrial fibrillation.

Journal article Semin Thorac Cardiovasc Surg · July 1989 The observations made under controlled experimental conditions provided us with a clearer understanding of the mechanisms involved in the generation and perpetuation of atrial fibrillation. The magnitude and rapidity of change that occurs in the activation ... Link to item Cite

Implementation of microcomputer operating room database.

Journal article Proceedings of Am Assoc Med Sys Inform · 1989 Cite

Right ventricular free wall isolation: effects on regional myocardial blood flow.

Journal article Ann Thorac Surg · October 1988 The right ventricular isolation procedure was developed to treat medically refractory, nonischemic right ventricular tachycardia. The effect of this procedure on regional myocardial blood flow to the isolated right ventricle was evaluated in 10 adult mongr ... Full text Link to item Cite

Hemodynamic consequences of right ventricular isolation: the contribution of the right ventricular free wall to cardiac performance.

Journal article Ann Thorac Surg · September 1988 Surgical isolation of the right ventricular free wall was performed in 10 dogs to evaluate both the hemodynamic effects of the procedure and the postoperative contribution of right ventricular free wall contraction to overall cardiac performance. Following ... Full text Link to item Cite

Electrical activity in the heart during hyperkalemic hypothermic cardioplegic arrest: site of origin and relationship to specialized conduction tissue.

Journal article Ann Thorac Surg · April 1987 Previous studies from this laboratory have shown that low-amplitude electrical activity (LEA) may occur during standard hyperkalemic hypothermic cardioplegic arrest and be undetected by routine monitoring techniques. The present study was designed to eluci ... Full text Link to item Cite

Cardiac cryosurgery: regional myocardial blood flow of ventricular cryolesions.

Journal article J Surg Res · November 1986 Cryosurgery is one of three methods introduced recently for the treatment of ventricular tachyarrhythmias. Cryothermic exposure ablates arrhythmogenic ventricular myocardium, and produces a dense fibrous scar with a sharp border to histologically normal ti ... Full text Link to item Cite

The effects of cardioplegic potassium concentration and myocardial temperature on electrical activity in the heart during elective cardioplegic arrest.

Journal article J Thorac Cardiovasc Surg · October 1986 A major objective of cardioplegic arrest for protection of the heart during cardiac operations is total electromechanical quiescence. Recent studies from our laboratory in which we used multiple bipolar intracardiac and unipolar intramural electrodes have ... Link to item Cite

The effect of chemical ablation of the endocardium on ventricular fibrillation threshold.

Journal article Circulation · September 1986 The purpose of this study was to examine the effects of ablation of the superficial endocardium and Purkinje network on left ventricular fibrillation threshold. Lugol's solution was applied through small ventriculotomies to the left and right ventricular e ... Full text Link to item Cite

Electrophysiologic effects of surgical isolation of the right ventricle.

Journal article Ann Thorac Surg · July 1986 Surgical isolation of the entire right ventricular free-wall was performed in ten dogs to evaluate the effects of the procedure on a variety of electrophysiologic measurements. Complete surgical isolation of the right ventricle was confirmed by determining ... Full text Link to item Cite

Cryosurgical modification of retrograde atrioventricular conduction. Implications for the surgical treatment of atrioventricular nodal reentry tachycardia.

Journal article J Thorac Cardiovasc Surg · June 1986 Paroxysmal supraventricular tachycardia resulting from atrioventricular nodal reentry is a common arrhythmia that usually responds to medical therapy. When atrioventricular nodal reentry tachycardia is refractory to medical therapy, cryoablation or endocar ... Link to item Cite

The electrophysiological effects of calcium channel blockade during standard hyperkalemic hypothermic cardioplegic arrest.

Journal article Ann Thorac Surg · June 1986 The addition of calcium channel-blocking agents to a standard hyperkalemic hypothermic cardioplegic solution has been examined both experimentally and clinically. None of these studies, however, have investigated the effect of calcium blockade during cardi ... Full text Link to item Cite

Surgical treatment of supraventricular tachyarrhythmias.

Journal article Surg Clin North Am · June 1985 The surgical treatment of supraventricular tachyarrhythmias has undergone considerable evolution since its inception in 1968 with the treatment of a patient with Wolff-Parkinson-White syndrome. At present, Wolff-Parkinson-White syndrome, atrioventricular n ... Full text Link to item Cite

Functional consequences of right ventricular isolation

Journal article Surgical Forum · 1984 Cite

Monitoring of the electrical status of the ventricle during cardioplegic arrest

Journal article Circulation · October 21, 1983 Present methods used to assess the status of myocardial preservation during cardioplegic arrest include monitoring the peripheral electrocardiogram (ECG) and ventricular myocardial temperature, and visual inspection of the heart to verify complete mechanic ... Cite

Conduction block after cardioplegic arrest: Prevention by augmented arterial hypothermia

Journal article Circulation · October 21, 1983 Atrioventricular conduction abnormalities have become more frequent since the reintroduction of cardioplegic techniques for myocardial preservation during cardiac surgery. An animal model was developed to clarify the role of atrial septal hypothermia in th ... Cite

Conduction block after cardioplegic arrest: prevention by augmented atrial hypothermia.

Journal article Circulation · September 1983 Atrioventricular conduction abnormalities have become more frequent since the reintroduction of cardioplegic techniques for myocardial preservation during cardiac surgery. An animal model was developed to clarify the role of atrial septal hypothermia in th ... Link to item Cite

Monitoring of the electrical status of the ventricle during cardioplegic arrest.

Journal article Circulation · September 1983 Present methods used to assess the status of myocardial preservation during cardioplegic arrest include monitoring the peripheral electrocardiogram (ECG) and ventricular myocardial temperature, and visual inspection of the heart to verify complete mechanic ... Link to item Cite

Ventricular cryosurgery: short-term effects on intramural electrophysiology.

Journal article Ann Thorac Surg · April 1983 The acute effects of cryothermia on regional electrophysiology were examined in order to devise a means of localizing and monitoring the intramural progression of ventricular cryolesions during a two-minute period of cryothermia application. Intramural uni ... Full text Link to item Cite

Cardiac cryosurgery: effects of myocardial temperature on cryolesion size.

Journal article Surgery · February 1983 Cryothermic ablation of myocardium and portions of the specialized cardiac conduction tissue has been employed successfully for the treatment of both supraventricular and ventricular tachyarrhythmias. As more uses have been found for cardiac cryosurgery, i ... Link to item Cite

Cryosurgery for cardiac arrhythmias: acute and chronic effects on coronary arteries.

Journal article Am J Cardiol · January 1, 1983 The use of cryosurgery near major coronary arteries for the treatment of supraventricular and ventricular tachyarrhythmias has caused concern over the possible deleterious acute and chronic effects of cryothermia on vessel patency and integrity. The presen ... Full text Link to item Cite

Elective prolongation of atrioventricular conduction by multiple discrete cryolesions: a new technique for the treatment of paroxysmal supraventricular tachycardia.

Journal article J Thorac Cardiovasc Surg · October 1982 The present study describes a surgical method for the permanent prolongation of atrioventricular (AV) conduction. In 22 dogs, a series of nine discrete cryolesions were placed along the perimeter of the triangle of Koch while the His bundle electrogram was ... Link to item Cite

The effects of airway pressure on cardiac function in intact dogs and man.

Journal article Circulation · July 1982 Ventilation with positive end-expiratory pressure (PEEP) is associated with reduced cardiac output, but the mechanisms involved are controversial. Possible explanations include increased intrathoracic pressure, reflex changes in myocardial inotropism, pulm ... Full text Link to item Cite

Encircling endocardial ventriculotomy for refractory ischemic ventricular tachycardia. II. Effects on regional myocardial blood flow.

Journal article J Thorac Cardiovasc Surg · June 1982 Previous experimental studies of the encircling endocardial ventriculotomy (EEV) have shown a significant alteration of normal local electrical activity within the encompassed region. Although this procedure may result in isolation of ventricular arrhythmi ... Link to item Cite

Encircling endocardial ventriculotomy for refractory ischemic ventricular tachycardia. III. Effects on regional left ventricular function.

Journal article J Thorac Cardiovasc Surg · June 1982 In order to assess the effects of the encircling endocardial ventriculotomy (EEV) on regional left ventricular function, we cannulated seven adult mongrel dogs for cardiopulmonary bypass. Two pairs of miniature pulse-transit transducers were placed in mid- ... Link to item Cite

Encircling endocardial ventriculotomy for refractory ischemic ventricular tachycardia. I. Electrophysiological effects.

Journal article J Thorac Cardiovasc Surg · June 1982 The direct endocardial surgical techniques introduced for the treatment of refractory ischemic ventricular tachyarrhythmias have resulted in decreased surgical mortality rates and increased success rates in comparison to previous indirect techniques. Since ... Link to item Cite

Analysis of pulsatile pulmonary artery blood flow in the unanesthetized dog.

Journal article J Appl Physiol Respir Environ Exerc Physiol · April 1981 Full text Link to item Cite

An analysis of the pulsatile hemodynamic responses of the pulmonary circulation to acute and chronic pulmonary venous hypertension in the awake dog.

Journal article Circ Res · December 1980 In this study we measured high fidelity pulsatile pressure and flow waveforms at the inlet to the pulmonary vascular bed to assess the differences in adaptation to acute and chronic pulmonary venous hypertension in awake dogs. Acute elevations in left atri ... Full text Link to item Cite

Surgical management of aortic abdominal aneurysms in patients with severe pulmonary insufficiency.

Journal article Surg Gynecol Obstet · September 1980 In view of the poor prognosis associated with the natural history of aortic abdominal aneurysms, this disorder is being surgically corrected in an increasing number of patients. There remains a group of patients with serious coexisting disease in whom care ... Link to item Cite

Pulmonary vascular impedance analysis of adaptation to chronically elevated blood flow in the awake dog.

Journal article Circ Res · August 1979 Pulsatile pulmonary hemodynamics were analyzed in a chronic awake canine high flow model. Standard mean flow and pulsatile flow hemodynamics were measured and alterations in the proximal pulmonary vascular physical properties were quantified by the charact ... Full text Link to item Cite