Anatomic predictors of distal landing zone failure after endovascular repair of thoracic aortic aneurysm†.

Objectives: To analyse anatomic factors of the distal landing zone (dLZ) associated with the durability of endovascular repair of thoracic aortic aneurysm (TAA).

Methods: Consecutive patients undergoing thoracic endovascular aortic repair (TEVAR) for undissected TAA were queried from a single centre from 2004 to 2022. Patient and operative factors were considered as well as detailed anatomic factors at the dLZ assessed by 3D reconstruction of pre-TEVAR imaging.

National Trends in the Use and Timing of Thoracic Endovascular Aneurysm Repair After Type B Aortic Dissection.

Background: The optimal management of uncomplicated type B aortic dissection (TBAD) has become controversial in recent years, especially concerning the use and timing of thoracic endovascular aneurysm repair (TEVAR). Here, we analyze a large national cohort over 11 years to understand the current national landscape of TBAD management, trends over time, and disparities in care across the United States.

Methods: Admissions for acute TBAD from 2010 to 2020 were identified in the Nationwide Readmissions Database, a large nationally representative sample of hospital admissions across 30 states.

Predicting Thoracic Aortic Dissection in a Diverse Biobank Using a Polygenic Risk Score.

Background: Thoracic aortic dissection is a life-threatening condition that often occurs in the presence of aortic dilation. However, currently there are limited clinical risk factors beyond aortic diameter (AoD) used to determine individual-level dissection risk.

Objectives: The purpose of this study was to determine whether common variant genetics can be used to improve identification of individuals most at risk for dissection.

Long-term outcomes of thoracic endovascular aortic repair for descending thoracic aortic aneurysms based on pooled results from FDA clinical trials.

Objective: Thoracic endovascular aortic repair (TEVAR) is the preferred treatment for descending thoracic aortic aneurysms, but long-term data are limited. This study assessed long-term results of TEVAR in early recipients of TEVAR devices who were enrolled in US Food and Drug Administration investigational device exemption clinical trials for aneurysm.

Methods: This was a single-center retrospective study including 179 patients enrolled in 14 clinical trials for TEVAR for descending thoracic aortic aneurysm between 2000 and 2019.

Malperfusion in Patients With Acute Type A Aortic Dissection: A Nationwide Analysis.

Background: This study describes in detail the clinical burden of malperfusion associated with acute type A aortic dissection (ATAAD) in a large, national cohort and the effect of treatment strategy on outcomes.

Methods: All patients undergoing repair of ATAAD between 2017 and 2020 in The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database were studied. Malperfusion was defined using STS definitions on the basis of imaging or the surgeon's evaluation.

Polygenic Scoring for Detection of Ascending Thoracic Aortic Dilation.

Background: Ascending thoracic aortic dilation is a complex heritable trait that involves modifiable and nonmodifiable risk factors. Polygenic scores (PGS) are increasingly used to assess risk for complex diseases. The degree to which a PGS can improve aortic diameter prediction in diverse populations is unknown.

When Is Laparotomy for Mesenteric Ischemia After Aortic Dissection Futile?

Background: Tissue necrosis from persistent mesenteric ischemia after aortic dissection may progress to sepsis and death without emergency laparotomy. However, the signs of mesenteric necrosis are common in patients experiencing nonsurvivable multisystem failure after aortic catastrophe. This study examined when and whether laparotomy offers a chance for meaningful survival in these patients.

Economic implications of the modern treatment paradigm of glioblastoma: an analysis of global cost estimates and their utility for cost assessment.

Introduction: Glioblastoma is the most common primary brain tumor in adults. Standard of care includes maximal surgical resection of the tumor followed by concurrent chemotherapy and radiation. The treatment of glioblastoma must account for an increased disease severity and treatment intensity compared to other cancers which place a significant cost burden on the patient and health system.

An additive score optimized by a genetic learning algorithm predicts readmission risk after glioblastoma resection.

Thirty-day readmission following glioblastoma (GBM) resection is not only correlated with decreased overall survival but also increasingly tied to quality metrics and reimbursement. This study aimed to determine factors linked with 30-day readmission to develop a simple risk stratification score. From 2005 to 2016, 666 unique resections (467 patients) of primary/recurrent tissue-confirmed glioblastoma were retrospectively identified.

Volume of frail patients predicts outcome in frail patients after cardiac surgery.

Objective: Recent data from major noncardiac surgery suggest that outcomes in frail patients are better predicted by a hospital's volume of frail patients specifically, rather than overall surgical volume. We sought to evaluate this "frailty volume-frailty outcome relationship" in patients undergoing cardiac surgery.

Methods: We studied 72,818 frail patients undergoing coronary artery bypass grafting or valve replacement surgery from 2010 to 2014 using the Nationwide Readmissions Database.

Predictors of 30-day readmission and resource utilization after thoracic endovascular aortic repair.

Objectives: The introduction and expansion of thoracic endovascular aortic repair (TEVAR) have revolutionized the treatment of a variety of thoracic aortic diseases. We sought to evaluate the incidence, causes, predictors and costs associated with 30-day readmission after TEVAR in a nationally representative cohort.

Methods: Adult patients undergoing isolated TEVAR were identified in the National Readmissions Database from 2010 to 2014.

Nationwide Analysis of 30-Day Readmissions After Esophagectomy: Causes, Costs, and Risk Factors.

Background: Postsurgical readmissions are an increasingly scrutinized marker of health care quality. We sought to estimate the rate, risk factors, causes, and costs associated with readmissions after esophagectomy in a large, nationally representative cohort.

Methods: We studied patients from the Nationwide Readmissions Database undergoing esophagectomy from 2010 to 2014.

Causes, Risk Factors, and Costs of 30-Day Readmissions After Mitral Valve Repair and Replacement.

Background: Postsurgical readmissions are an increasingly scrutinized marker of health care quality. We sought to estimate the risk factors and costs associated with readmissions after mitral valve (MV) surgery in a large, nationally representative cohort.

Methods: Adult patients undergoing MV repair or replacement were queried from the National Readmissions Database from 2010 to 2014.

Liver disease is an independent predictor of poor 30-day outcomes following surgery for degenerative disease of the cervical spine.

Background And Context: The impact of underlying liver disease on surgical outcomes has been recognized in a wide variety of surgical disciplines. However, less empiric data are available about the importance of liver disease in spinal surgery.

Purpose: To measure the independent impact of underlying liver disease on 30-day outcomes following surgery for the degenerative cervical spine.

Complications Predicting Perioperative Mortality in Patients Undergoing Elective Craniotomy: A Population-Based Study.

Objective: The objective of this study was to assess the independent effect of complications on 30-day mortality in 32,695 patients undergoing elective craniotomy.

Methods: The American College of Surgeons National Surgical Quality Improvement Program was queried for patients undergoing elective craniotomy from 2006 to 2015. Multivariate logistic regression was used to examine the effect of complications on mortality independent of preoperative risk and other postoperative complications.

The Effect of Underlying Liver Disease on Perioperative Outcomes Following Craniotomy for Tumor: An American College of Surgeons National Quality Improvement Program Analysis.

Background: The association between underlying liver disease and poor surgical outcomes has been well documented across a wide variety of surgical disciplines. However, little is known about the importance of liver disease in neurosurgery. In this report, we assess the independent effect of liver disease on perioperative outcomes in patients undergoing craniotomy for tumor.

Pseudohypoparathyroidism type 1B in a patient conceived by in vitro fertilization: another imprinting disorder reported with assisted reproductive technology.

Pseudohypoparathyroidism type 1B (PHP1B) is characterized by renal tubular resistance to parathyroid hormone (PTH) leading to hyperphosphatemia, hypocalcemia, elevated PTH, and hyperparathyroid bone changes. PHP1B is an imprinting disorder that results from loss of methylation at the maternal GNAS gene, which suppresses transcription of the alpha subunit of the stimulatory G protein of the PTH receptor. Emerging evidence supports an association between assisted reproductive technologies (ART) and imprinting disorders; however, there is currently little evidence linking PHP1B and ART.

Outcomes and Prognostic Factors in Pediatric Oligodendroglioma: A Population-Based Study.

Background/aims: Pediatric oligodendroglioma (pODG) is a rare primary brain tumor that remains poorly understood. Demographics, outcomes, and prognostic factors were analyzed in 346 pODG cases from the Surveillance, Epidemiology, and End Results database.

Methods: Gender, race, age, tumor location, tumor size, tumor grade, extent of resection, and use of radiotherapy were evaluated with respect to overall survival (OS) by univariate and multivariate analysis.