Christina M Vassileva's research while affiliated with University of Massachusetts Medical School and other places

... This portfolio of STS composite measures has been expanded to multiprocedural composite measures for individual surgeons 3 as well as for hospitals and cardiac surgical groups. 4 As comprehensive as this approach has been, there is mounting evidence that the evaluation of failure to rescue (FTR) may provide additional information not specifically apparent in the more traditional risk-adjusted mortality and morbidity metrics. In an effort to better understand surgical mortality, Silber and colleagues 5 introduced the concept of failure to rescue, defined as death during hospitalization among patients who had a complication. ...

... Frailty, a measure of baseline physiological reserve, has been reported to be an independent predictor of FTR following surgery [4,12]. Development of FTR metrics that incorporates frailty and evaluates major complications specific to neurosurgical patients would help provide more accurate information that could be used regarding recovery, futile care, and healthcare resource utilization [17,22,23]. This knowledge could be utilized to guide discussions on goals of care when certain major complications develop, since some very frail patients would be unlikely to benefit from aggressive resuscitation measures or excessive intensive care. ...

... 47,48 The recently developed STS 2021 ACS risk models for operative mortality, major morbidity and combined mortality/ morbidity for multiple valve operations include AVR + MVR/r and AVR + MVR/r + CABG. 49 Although the STS risk score is used to predict the operative mortality and morbidity, it is the strongest predictor of long-term survival following TAVI 50 It does have limitations, such as that it cannot be used to study the other type of cardiac surgery that have not yet been included such as Maze procedure for surgical ablation of atrial fibrillation. 51 To summarize, widely used in adult cardiac surgery, the STS risk models forecast operative mortality and morbidity while emphasizing quality measurement, practice improvement, public reporting, and research. ...

... We found excellent post-surgical mortality, post-surgical MR and hospital re-admission outcomes in both MAD positive and MAD negative patients in our cohort comparable to other post-surgical MVP trials and registry data [27][28][29] Our rates of MVP replacement were 19.8%, which is higher than other trials [21], possibly due to increased patient age and co-morbidities in our cohort, as well as surgical experience and preference at our centre. However, it is reassuring that 90.6% of MAD positive patients underwent successful repair, which suggests the presence of MAD does not compromise MV surgical reparability. ...

... Tese lesions may be very poorly tolerated in solidarity and, when combined, may conceivably increase the risk of cardiac death as well as severe hemodynamic perturbations intraoperatively. A review of the Society of Toracic Surgeons dataset of 623,039 patients found the operative mortality rate to be nearly double in multivalvular disease when compared to single-valve procedures [6]. Approach to these patients, thus, requires a thorough preoperative evaluation, understanding of pathophysiological hemodynamic consequences, and careful anesthetic planning. ...

... It remains controversial whether MV repair or replacement is better for elderly patients with degenerative MR. In previous studies on MV repair vs. MV replacement in elderly patients, a study using a national database demonstrated that the early results of MV repair were signi cantly better than those of MV replacement (17). However, in this study, the patient characteristics differed between the groups, and there were more patients with older age, diabetes mellitus, and chronic lung disease in the MV replacement group. ...

... [5][6][7][8][9][10][11][12][13][14] Similar racial disparities were identified in orthopedic surgery, oncological surgery, cardiothoracic surgery, and a number of other surgical fields. 3,[15][16][17][18][19][20][21][22][23][24] Evaluations of racial disparities in postsurgical outcomes among Black and Hispanic and Latino patients are well documented, with the former finding significantly poorer clinical outcomes. These studies are instrumental in discussing the complex interplay between race and surgical outcomes. ...

... Surgical risk was estimated through the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) score [17]. The risk of mortality and morbidity for aortic intervention was calculated using the Society of Thoracic Surgeons (STS) score [18]. ...

... Patients ≥75 years had increased prevalence of comorbidities, impaired RV function and were more likely to present with NYHA class III symptoms and SMR in comparison to younger patients. Therefore, elderly patients exhibit an increased perioperative surgical risk (8), according to established risk stratification models (e.g., The Society of Thoracic Surgeons (STS) predicted risk of mortality (PROM) score) (STS PROM: 1.9% vs. 0.4%; p < 0.001) ( Table 1) (11).. However, relevance of standard risk stratification tools to predict risk in elderly patients undergoing minimally-invasive MVS remains unclear (12). ...

... Redo surgery including MVr and mitral valve replacement (MVR) has been the gold standard for failed surgical MVr, defined by the recurrence of moderate or severe MR, mitral valve re-operation for any reason, such as mitral regurgitation, stenosis, hemolysis, or infective endocarditis [4]. However, it is associated with increased technical difficulty inherent to reoperations and greater frailty of the patients [5,6]. ...