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14. Coronary Artery Bypass Surgery Without Saphenous Vein Grafting

Author

Royse, Alistair, primary, Ren, Justin, additional, Royse, Colin, additional, Tian, David H., additional, Fremes, Stephen, additional, Gaudino, Mario, additional, Benedetto, Umberto, additional, Woo, Y. Joseph, additional, Goldstone, Andrew B., additional, Davierwala, Piroze, additional, Borger, Michael, additional, Vallely, Michael, additional, Reid, Christopher M., additional, Rocha, Rodolfo, additional, Glineur, David, additional, Grau, Juan, additional, Shaw, Richard, additional, Paterson, Hugh, additional, El-Ansary, Doa, additional, Boggett, Stuart, additional, Srivastav, Nilesh, additional, Pawanis, Zulfayandi, additional, Canty, David, additional, and Bellomo, Rinaldo, additional

Published
2022
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15. Survival of multiple arterial grafting in diabetic populations: a 20-year national experience.

Author

Ren, Justin, Royse, Colin, Tian, David H, Gupta, Aashray, and Royse, Alistair

Subjects
CORONARY artery bypass, ARTERIAL grafts, PEOPLE with diabetes, INTERNAL thoracic artery
Abstract

Open in new tab Download slide OBJECTIVES Diabetics may have diminished survival after coronary artery bypass grafting even with multiple arterial revascularization. We compared multi-arterial versus single-arterial grafting (SAG) survival in diabetic and non-diabetic patients undergoing primary isolated bypass surgery. METHODS This is a retrospective analysis of the Australian and New Zealand Society of Cardiac-Thoracic Surgical Database from June 2001 to January 2020. Patients were classified as having either single or multiple arterial grafting irrespective of the number of venous grafts. The end points were long-term all-cause mortality and 30-day clinical outcomes, which was compared in 1:1 propensity score-matched patients. Cox regression model was used to assess interactions between diabetes and the treatment effect of multi-arterial grafting, reported as hazard ratios (HRs) and confidence intervals (CIs). Short-term outcomes were compared with McNemar's paired t -test. RESULTS From 69 624 patients, matching generated 17 474 non-diabetic and 10 989 diabetic patient pairs. At a median [interquartile range] of 5.9 [3.2–9.6] years postoperative, mortality was significantly lower after multi-arterial grafting for both diabetic (HR, 0.83; 95% CI, 0.76–0.90, P  < 0.001) and non-diabetic (HR, 0.88; 95% CI, 0.82–0.95; P  < 0.001) cohorts than SAG. The incidence of 30-day myocardial infarction was significantly higher in single than multiple arterial grafting for both cohorts (diabetic, P  = 0.029; non-diabetic, P  < 0.001). The interaction analysis suggested an insignificant effect of diabetes (P  = 0.55) on the observed survival advantage. Further stratification by diabetic management generated consistent results. CONCLUSIONS Multi-arterial grafting was associated with improved overall survival compared to SAG for both non-diabetic and diabetic patients. [ABSTRACT FROM AUTHOR]

Published
2023
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20. Long-Term Functional Outcomes After Sepsis for Adult and Pediatric Critical Care Patients-Protocol for a Systematic Review

Author

Simpson, Adam, Long, Deborah, Fleischmann-Struzek, Carolin, Minogue, Jessicah, Venkatesh, Balasubramanian, Hammond, Naomi E, Tian, David H, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Simpson, Adam, Long, Deborah, Fleischmann-Struzek, Carolin, Minogue, Jessicah, Venkatesh, Balasubramanian, Hammond, Naomi E, Tian, David H, and Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598

Abstract

Objective: Sepsis is responsible for a massive burden of disease, with a global estimate of 48.9 million cases resulting in approximately 11 million deaths annually. Survivors of sepsis may also experience long-term impairments that can persist for years after hospital discharge. These cognitive, physical and/or psychosocial deficits may contribute to a lower health related quality of life and represent a significant ongoing burden to the individual, the community and the health care system. We aim to systematically review the available evidence on long-term functional and quality of life outcomes after sepsis in children and adults. Data Sources: Medline, EMBASE, and CINAHL will be searched for eligible studies. Study Selection: Studies of adult and pediatric survivors of sepsis who had required admission to intensive care will be included. A minimum 6 month prospective follow up will be required. Accepted outcomes will be any validated measure of health-related quality of life (HRQoL) or functional deficits, using the Post-Intensive Care Syndrome (PICS) framework of cognitive, physical or psychosocial outcomes. Data Extraction: Data extraction will include information related to study characteristics, population characteristics, clinical criteria and outcomes. Data Synthesis: Studies meeting the inclusion criteria will be presented descriptively separated for pediatric and adult age groups. Meta-analysis will be attempted if sufficient primary data from several studies applying the same tests and outcomes are available. The primary outcome is HRQoL after sepsis; secondary outcomes include the functional status at follow-up. Conclusions: This systematic review will define the long-term impact of sepsis survivorship. The data will contribute to informing patient, clinician and stakeholder decisions and guide further research and resource management.

Published
2021

22. Long-term outcomes of sutureless and rapid-deployment aortic valve replacement: a systematic review and meta-analysis

Author

Williams, Michael L., primary, Flynn, Campbell D., additional, Mamo, Andrew A., additional, Tian, David H., additional, Kappert, Utz, additional, Wilbring, Manuel, additional, Folliguet, Thierry, additional, Fiore, Antonio, additional, Miceli, Antonio, additional, D’Onofrio, Augusto, additional, Cibin, Giorgia, additional, Gerosa, Gino, additional, Glauber, Mattia, additional, Fischlein, Theodor, additional, and Pollari, Francesco, additional

Published
2020
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26. Systematic review and meta-analysis of surgical outcomes comparing mechanical valve replacement and bioprosthetic valve replacement in infective endocarditis

Author

Flynn, Campbell D., primary, Curran, Neil P., additional, Chan, Stephanie, additional, Zegri-Reiriz, Isabel, additional, Tauron, Manel, additional, Tian, David H., additional, Pettersson, Gosta B., additional, Coselli, Joseph S., additional, Misfeld, Martin, additional, Antunes, Manuel J., additional, Mestres, Carlos A., additional, and Quintana, Eduard, additional

Published
2019
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33. The Society for Translational Medicine: indications and methods of percutaneous transthoracic needle biopsy for diagnosis of lung cancer

Author

Zhou, Qinghua, primary, Dong, Jingsi, additional, He, Jie, additional, Liu, Deruo, additional, Tian, David H., additional, Gao, Shugeng, additional, Li, Shanqing, additional, Liu, Lunxu, additional, He, Jianxing, additional, Huang, Yunchao, additional, Xu, Shidong, additional, Mao, Weimin, additional, Tan, Qunyou, additional, Chen, Chun, additional, Li, Xiaofei, additional, Zhang, Zhu, additional, Jiang, Gening, additional, Xu, Lin, additional, Zhang, Lanjun, additional, Fu, Jianhua, additional, Li, Hui, additional, Wang, Qun, additional, Tan, Lijie, additional, Li, Danqing, additional, Zhou, Qinghua, additional, Fu, Xiangning, additional, Jiang, Zhongmin, additional, Chen, Haiquan, additional, Fang, Wentao, additional, Zhang, Xun, additional, Li, Yin, additional, Tong, Ti, additional, Yu, Zhentao, additional, Liu, Yongyu, additional, Zhi, Xiuyi, additional, Yan, Tiansheng, additional, Zhang, Xingyi, additional, Casal, Roberto F., additional, Pompeo, Eugenio, additional, Carretta, Angelo, additional, Riquet, Marc, additional, Rena, Ottavio, additional, Falcoz, Pierre-Emmanuel, additional, Saji, Hisashi, additional, Khan, Ali Zamir, additional, Danguilan, Jose Luis, additional, Gonzalez-Rivas, Diego, additional, Guibert, Nicolas, additional, Zhu, Chengchu, additional, and Shen, Jianfei, additional

Published
2018
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38. Systematic review and meta-analysis of surgical outcomes in Marfan patients undergoing aortic root surgery by composite-valve graft or valve sparing root replacement.

Author

UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, Flynn, Campbell D, Tian, David H, Wilson-Smith, Ashley, David, Tirone, Matalanis, George, Misfeld, Martin, Mastrobuoni, Stefano, El Khoury, Gebrine, Yan, Tristan D, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, Flynn, Campbell D, Tian, David H, Wilson-Smith, Ashley, David, Tirone, Matalanis, George, Misfeld, Martin, Mastrobuoni, Stefano, El Khoury, Gebrine, and Yan, Tristan D

Abstract

A major, life-limiting feature of Marfan syndrome (MFS) is the presence of aneurysmal disease. Cardiovascular intervention has dramatically improved the life expectancy of Marfan patients. Traditionally, the management of aortic root disease has been undertaken with composite-valve graft replacing the aortic valve and proximal aorta; more recently, valve sparing procedures have been developed to avoid the need for anticoagulation. This meta-analysis assesses the important surgical outcomes of the two surgical techniques. A systematic review and meta-analysis of 23 studies reporting the outcomes of aortic root surgery in Marfan patients with data extracted for outcomes of early and late mortality, thromboembolic events, late bleeding complications and surgical reintervention rates. The outcomes of 2,976 Marfan patients undergoing aortic root surgery were analysed, 1,624 patients were treated with composite valve graft (CVG) and 1,352 patients were treated with valve sparing root replacement (VSRR). When compared against CVG, VSRR was associated with reduced risk of thromboembolism (OR =0.32; 95% CI, 0.16-0.62, P=0.0008), late hemorrhagic complications (OR =0.18; 95% CI, 0.07-0.45; P=0.0003) and endocarditis (OR =0.27; 95% CI, 0.10-0.68; P=0.006). Importantly there was no significant difference in reintervention rates between VSRR and CVG (OR =0.89; 95% CI, 0.35-2.24; P=0.80). There is an increasing body of evidence that VSRR can be reliably performed in Marfan patients, resulting in a durable repair with no increased risk of re-operation compared to CVG, thus avoiding the need for systemic anticoagulation in selected patients.

Published
2017

39. The ARCH Projects: design and rationale (IAASSG 001)

Author

Yan, Tristan D., Tian, David H., LeMaire, Scott A., Misfeld, Martin, Elefteriades, John A., Chen, Edward P., Chad Hughes, G., Kazui, Teruhisa, Griepp, Randall B., Kouchoukos, Nicholas T., Bannon, Paul G., Underwood, Malcolm J., Mohr, Friedrich-Wilhelm, Oo, Aung, Sundt, Thoralf M., Bavaria, Joseph E., Di Bartolomeo, Roberto, Di Eusanio, Marco, Roselli, Eric E., Beyersdorf, Friedhelm, Carrel, Thierry P., Corvera, Joel S., Della Corte, Alessandro, Ehrlich, Marek, Hoffman, Andras, Jakob, Heinz, Matalanis, George, Numata, Satoshi, Patel, Himanshu J., Pochettino, Alberto, Safi, Hazim J., Estrera, Anthony, Perreas, Konstantinos G., Sinatra, Riccardo, Trimarchi, Santi, Sun, Li-Zhong, Tabata, Minoru, Wang, Chunsheng, Haverich, Axel, Shrestha, Malakh, Okita, Yutaka, Coselli, Joseph, Yan, Tristan D., Tian, David H., LeMaire, Scott A., Misfeld, Martin, Elefteriades, John A., Chen, Edward P., Chad Hughes, G., Kazui, Teruhisa, Griepp, Randall B., Kouchoukos, Nicholas T., Bannon, Paul G., Underwood, Malcolm J., Mohr, Friedrich-Wilhelm, Oo, Aung, Sundt, Thoralf M., Bavaria, Joseph E., Di Bartolomeo, Roberto, Di Eusanio, Marco, Roselli, Eric E., Beyersdorf, Friedhelm, Carrel, Thierry P., Corvera, Joel S., Della Corte, Alessandro, Ehrlich, Marek, Hoffman, Andras, Jakob, Heinz, Matalanis, George, Numata, Satoshi, Patel, Himanshu J., Pochettino, Alberto, Safi, Hazim J., Estrera, Anthony, Perreas, Konstantinos G., Sinatra, Riccardo, Trimarchi, Santi, Sun, Li-Zhong, Tabata, Minoru, Wang, Chunsheng, Haverich, Axel, Shrestha, Malakh, Okita, Yutaka, and Coselli, Joseph

Abstract

OBJECTIVE A number of factors limit the effectiveness of current aortic arch studies in assessing optimal neuroprotection strategies, including insufficient patient numbers, heterogenous definitions of clinical variables, multiple technical strategies, inadequate reporting of surgical outcomes and a lack of collaborative effort. We have formed an international coalition of centres to provide more robust investigations into this topic. METHODS High-volume aortic arch centres were identified from the literature and contacted for recruitment. A Research Steering Committee of expert arch surgeons was convened to oversee the direction of the research. RESULTS The International Aortic Arch Surgery Study Group has been formed by 41 arch surgeons from 10 countries to better evaluate patient outcomes after aortic arch surgery. Several projects, including the establishment of a multi-institutional retrospective database, randomized controlled trials and a prospectively collected database, are currently underway. CONCLUSIONS Such a collaborative effort will herald a turning point in the surgical management of aortic arch pathologies and will provide better powered analyses to assess the impact of varying surgical techniques on mortality and morbidity, identify predictors for neurological and operative risk, formulate and validate risk predictor models and review long-term survival outcomes and quality-of-life after arch surgery

Published
2017

47. Open surgical repair for chronic type B aortic dissection: a systematic review

Author

Tian, David H., De Silva, Ramesh P., Wang, Tom, and Yan, Tristan D.

Subjects
Systematic Review
Abstract

The treatment of chronic type B aortic dissection (CBAD) remains complicated. Thoracic endovascular aortic repair (TEVAR) has supplanted open surgical repair (OSR) as the preferred surgical treatment for CBAD. Despite TEVAR's superior short-term results, much less is understood about its long-term outcomes. As much of the understanding of OSR originates from historical report, contemporary series, with modern surgical techniques and technologies, may present an alternative to TEVAR. The present systematic review will assess the short- and long-term outcomes of historic and contemporary series of OSR for CBAD.Electronic searches were performed using six databases from their inception to March 2014. Relevant studies with OSRs for chronic type B dissection were identified. Data were extracted by two independent reviewers and analyzed according to predefined clinical endpoints. Studies were sub-classified into the pre-endovascular (historic series) and endovascular era (contemporary series) depending on whether the majority of cases were performed after 1999.Nineteen studies were identified for inclusion for quantitative analysis. Pooled short-term mortality was 11.1% overall, and 7.5% in the nine contemporary studies. Stroke, spinal cord ischemia, renal dysfunction, and reoperation for bleeding were 5.9%, 4.9%, 8.1%, and 8.1%, respectively, for the contemporary series. Absolute late reintervention was identified in 13.3% of patients overall, and in 11.3% of patients in the contemporary series. Aggregated survival at 1-, 3-, 5-, and 10-years of all patients were 82.1%, 74.1%, 66.3%, and 50.8%, respectively.OSR for chronic type B dissection in the contemporary era offers acceptable results. Management approaches should be considered carefully, taking into account both short-term and long-term complications. More research is required to clarify specific indications for OSR and TEVAR in chronic type B dissections.

Published
2014

48. Type B aortic dissection

Author

Harris, Christopher G., Croce, Beth, and Tian, David H.

Subjects
ACS Patient Page
Published
2014

49. Meta-analysis of intentional sublobar resections versus lobectomy for early stage non-small cell lung cancer

Author

Cao, Christopher, Gupta, Sunil, Chandrakumar, David, Tian, David H., Black, Deborah, and Yan, Tristan D.

Subjects
Systematic Review
Abstract

Surgical resection is the preferred treatment modality for eligible candidates with non-small cell lung cancer (NSCLC). However, the selection of sublobar resection versus lobectomy for early-stage NSCLC remains controversial. Previous meta-analyses comparing these two procedures presented data without considering the significant differences in the patient selection processes in individual studies. The present study aimed to compare the overall survival (OS) and disease-free survival (DFS) outcomes of patients who underwent sublobar resections who were also eligible for lobectomy procedures with those who underwent lobectomy.An electronic search was conducted using five online databases from their dates of inception to December 2013. Studies were selected according to predefined inclusion criteria and meta-analyzed using hazard ratio (HR) calculations.Twelve studies met the selection criteria, including 1,078 patients who underwent sublobar resections and 1,667 patients who underwent lobectomies. From the available data, there was no significant differences in OS [HR 0.91; 95% confidence interval (CI) 0.64-1.29] or DFS (HR 0.82; 95% CI 0.60-1.12) between the two treatment arms. In addition, no significant OS difference was detected for patients who underwent segmentectomies compared to lobectomies (HR 1.04; 95% CI 0.66-1.63, P=0.86).Using the available data in the current literature, patients who underwent sublobar resection for small, peripheral NSCLC after intentional selection rather than ineligibility for greater resections achieved similar long-term survival outcomes as those who underwent lobectomies. However, patients included for the present meta-analysis were a highly selected cohort and these results should be interpreted with caution. The importance of the patient selection process in individual studies must be acknowledged to avoid conflicting outcomes in future meta-analyses.

Published
2014

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