Abstract:
OBJECTIVES:This study evaluated the effect of both hospital and surgeon annual case volumes on patient mortality following coronary artery bypass grafting (CABG). METHODS:PubMed and Embase databases were searched for clinical studies on CABG. The outcome was mortality, including operative mortality, in-hospital mortality and 30-day mortality. RESULTS:Twenty-five studies involving 3 492 101 participants and 143 951 deaths were included for hospital volume, and 4 studies involving 108 356 participants and 2811 deaths were included for surgeon volume. The pooled estimate revealed that both hospital and surgeon annual case volumes were inversely associated with mortality in patients after CABG [odds ratio (OR) for hospital: 0.62, 95% confidence interval (CI) 0.56-0.69; P < 0.001; OR for surgeon: 0.51, 95% CI 0.31- 0.83; P < 0.001] with high heterogeneity (hospital: I2 = 90.6%, Pheterogeneity < 0.001; surgeon: I2 = 86.8%, Pheterogeneity < 0.001). The relationship remained consistent and robust in most subgroup and sensitivity analyses. Our meta-regression analysis of time suggested that the strength of the negative associations between volume and mortality for both hospitals and surgeons remained unattenuated over time even though the CABG mortality gradually decreased over time. The dose-response analysis suggested a non-linear relationship between both hospital and surgeon annual case volumes and mortality (both Pnon-linearity = 0.001). CONCLUSIONS:Both higher hospital and surgeon annual case volumes are associated with lower mortality in patients undergoing CABG, and the negative associations remain unattenuated over time. CLINICAL REGISTRATION NUMBER:The study was registered at PROSPERO as CRD42017067912.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Tie HT,Shi R,Zhou Q,Wang K,Zheng XQ,Wu QCdoi
10.1093/icvts/ivz151subject
Has Abstractpub_date
2019-10-01 00:00:00pages
568-575issue
4eissn
1569-9293issn
1569-9285pii
5522193journal_volume
29pub_type
杂志文章,meta分析abstract::We report on an uncommon case of a 10-month-old patient who required early surgical closure of an ostium secumdum atrial septal defect due to the concomitant presence of a big subcarinal bronchogenic cyst compressing the left atrium and, therefore, increasing the left-to-right shunt. It led to refractory congestive he...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.171280
更新日期:2008-05-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether changing operative technique based on epiaortic ultrasound reduces the incidence of intra-operative stroke during cardiac surgery? Altogether 179 papers were found using the reported search, of w...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00220-2
更新日期:2004-03-01 00:00:00
abstract::Shed blood is known to be a source of lipid micro-emboli in cardiac surgery. The aim of this study was to characterize the occurrence of these particles at different stages of the operation, and to study their occurrence in the circulation at multiple time-points after the retransfusion of shed blood. Forty-four patie...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.187021
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:Mechanical trauma occurring during pulmonary resection through both video-assisted thoracic surgery (VATS) or thoracotomy causes profound alterations in cytokines and the cellular network. The aim of this study was to analyse biological changes occurring in both the microenvironment (wound site) and macroenv...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy231
更新日期:2019-02-01 00:00:00
abstract::Recent studies define functional mitral regurgitation (MR) and worsened left ventricular (LV) systolic indices as the widening of the dimension between papillary muscle heads; consequently, narrowing this distance may improve the mitral valve and LV function. Thirty (22 males; mean age: 57+/-7 years) candidates for CA...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.118430
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the efficacy and safety of Edwards SAPIEN-XT or SAPIEN-3 transcatheter heart valves via transaortic (TAo) access. METHODS:A total of 100 consecutive patients with severe symptomatic aortic stenosis undergoing TAo-transcatheter aortic valve implantation (TAVI) were included in this observational ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw277
更新日期:2017-01-01 00:00:00
abstract::Aortic mural thrombi in a normal (non-aneurysmal or minimally atherosclerotic) vessel are an uncommon condition. They are usually located in the descending aorta and, less frequently, in the aortic arch or in the abdominal aorta. The typical clinical presentation is the appearance of symptoms/signs of peripheral arter...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv349
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:Minimally invasive cardiac valve surgery is safe, effective and increasingly popular. It is performed worldwide with the use of either external aortic clamping or endoaortic balloon occlusion. METHODS:We conducted a literature search using MEDLINE, EMBASE, Scopus and Web of Science. Primary outcomes include...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy016
更新日期:2018-08-01 00:00:00
abstract::This retrospective study investigated whether withdrawal of aprotinin from combined low-dose aprotinin/tranexamic acid (TXA) antifibrinolytic therapy altered postoperative blood loss and transfusion requirements in patients undergoing cardiothoracic surgery employing cardiopulmonary bypass (CPB). The study included da...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.250936
更新日期:2011-02-01 00:00:00
abstract::Transcatheter closure of secundum atrial septal defect has become an alternative to surgery. We present a patient with hemodynamic collapse secondary to cardiac perforation occurring 36 h after the placement of an Amplatzer Septal Occluder and discuss complications of this kind of device. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.100669
更新日期:2005-06-01 00:00:00
abstract::The radial artery (RA) beside the left internal mammary artery and veins is often used for coronary artery bypass grafting. The aim of this study was to assess arm temperature changes after removal of the radial artery and determine whether there is an effect on hand function. Between April and December 2005, fifty pa...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 临床试验,杂志文章
doi:10.1510/icvts.2007.151795
更新日期:2007-10-01 00:00:00
abstract::In patients undergoing total arch replacement with protruding or mobile atheroma in the proximal aorta, we isolate cerebral circulation from systemic one by starting selective cerebral perfusion (SCP) before systemic arterial perfusion to prevent aortogenic embolic stroke. We disclose the safety of this isolation tech...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.164137
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:Surgery is the standard treatment in early-stage non-small-cell lung cancer and select cases of small-cell lung cancer, but gender differences in its use and outcome are poorly known. Gender differences in surgical resection rates and long-term survival after lung cancer surgery were therefore investigated. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivab006
更新日期:2021-02-01 00:00:00
abstract::A 57-year-old woman was admitted to our hospital with complaints of recent onset of dyspnea on exertion. A chest computed tomography revealed a large mediastinal mass which extrinsically compressed the heart and mediastinal structures, occupying one half of the hemithorax. A needle biopsy was performed to find a thymo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.177162
更新日期:2008-12-01 00:00:00
abstract::A 53 year-old woman had been followed up since 1996 after receiving bilateral adrenalectomy for the treatment of bilateral adrenal pheochromocytoma in von Hippel-Lindau (VHL) disease. In March 2003, she suffered from cough, dizziness and faint, and was referred to our hospital. The radiographic findings exhibited the ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.096784
更新日期:2005-02-01 00:00:00
abstract::The rotary blood pump (the HeartWare® Ventricular Assist Device) from HeartWare® (Medtronic) is an established left ventricular assist device and usually implanted via sternotomy. To reduce the invasiveness of the implant procedure and to optimize the position of the inflow cannula, we propose an alternative implant t...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy183
更新日期:2018-12-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest (DHCA)? Altogether, more than 62 papers were found using the reported search, of which 7 represent...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivt184
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:The Synergy CircuLite micropump is a novel partial-support miniature left ventricular assist device that propels 2-3 l/min blood from the left atrium into the right subclavian artery. The ability of currently available investigative modalities to confirm Synergy pump malfunction is limited. The Synergy speed...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu236
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVES:A 180/180° configuration has been reported to increase repair durability after valve-sparing aortic root replacement (V-SARR) for bicuspid aortic valve (BAV) disease. We studied the impact of commissural angular configuration (CAC) and of BAV type on valve performance after V-SARR. METHODS:A total of 85 BAV...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu123
更新日期:2014-09-01 00:00:00
abstract::A 68-year-old man presented with destruction of his sternum after cardiac surgery. Classical management with multiple debridements, vacuum dressings and antibiotics failed. A replacement of his sternum was performed using an antibiotic-loaded porous alumina ceramic sternum. Despite the infected wound, the ceramic ster...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz182
更新日期:2019-12-01 00:00:00
abstract::Surgery of aspergilloma has been renowned to be technically challenging and has a high complication rate. We have already demonstrated an improved outcome as a result of a reduction in complex cases related to history of tuberculosis. In this paper we will evaluate whether this time trend has continued during recent y...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.265553
更新日期:2011-10-01 00:00:00
abstract::Positron-emission tomography scans (PET) with fluorine-18-fluorodeoxyglucose ((18)F- FDG) are usually negative in leiomyomas. Two patients underwent a PET that showed an increased (18)F- FDG uptake of the distal oesophagus suggestive for malignancy. Both patients were operated on and histologic examination revealed a ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr037
更新日期:2012-02-01 00:00:00
abstract::Cardiac myxomas are the commonest benign tumour of the heart. We are describing a rare presentation of a myxoma in a patient with renal cell carcinoma (RCC). Since there was no single reported case of myxoma with RCC, a presumptive diagnosis of RCC with right atrial extension of tumour thrombus was made. Both the tumo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.227504
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:A number of meta-analytical and database studies have sought to compare open, video-assisted thoracoscopic surgery (VATS) and robotic operative approaches to lobectomy, often with conflicting results. Our objective was to perform a comprehensive review of these meta-analytical and database studies published ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析
doi:10.1093/icvts/ivy315
更新日期:2019-04-01 00:00:00
abstract::The surgical approach to esophagectomy is variable. A number of factors are considered when determining the optimal approach to esophagectomy: location and extent of disease, fibrosis, additional patient factors and surgeon preference. One of the disadvantages to some approaches is the need for a change in position, w...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.240853
更新日期:2010-11-01 00:00:00
abstract::Coarctation of thoracic aorta is an uncommon diagnosis in adults. Catheter-based intervention consisting of primary ballooning and stenting is becoming one of the methods of choice for the treatment of native coarctation. We describe the case of a young adult with coarctation of the aorta treated unsuccessfully with p...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.265264
更新日期:2011-07-01 00:00:00
abstract::We report an unusual complication of left-sided diaphragmatic plication, namely bleeding from the spleen due to tearing of adhesions between the spleen and the abdominal aspect of the diaphragm. We believe that making a small incision in the diaphragm prior to the plication to identify and divide the adhesions could h...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.214288
更新日期:2009-12-01 00:00:00
abstract::Five days following bilateral thoracoscopic lung volume reduction surgery for emphysema, a 63-year-old man underwent reoperation for closure of a massive bronchopleural fistula. It was discovered intraoperatively that the fistula was located distant from prior staple lines or resection sites from his surgery. This cas...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.197434
更新日期:2009-04-01 00:00:00
abstract::Inflammatory myofibroblastic tumour (IMT) or inflammatory pseudotumour is a histologically distinctive lesion occurring primarily in the viscera and soft tissue of children and young adults. We report an unusual case of IMT which had undergone malignant transformation in the chest wall at the pacemaker site. A 64-year...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.221945
更新日期:2010-03-01 00:00:00
abstract::Concomitant aortic and mitral valve replacement or concomitant aortic valve replacement and mitral repair can be a challenge for the cardiac surgeon: in particular, because of their structure and design, two bioprosthetic heart valves or an aortic valve prosthesis and a rigid mitral ring can interfere at the level of ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu204
更新日期:2014-10-01 00:00:00