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Quantifying the learning curve for pulmonary thromboendarterectomy

Overview of attention for article published in Journal of Cardiothoracic Surgery, December 2017
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Title
Quantifying the learning curve for pulmonary thromboendarterectomy
Published in
Journal of Cardiothoracic Surgery, December 2017
DOI 10.1186/s13019-017-0686-1
Pubmed ID
Authors

Smita Sihag, Bao Le, Alison S. Witkin, Josanna M. Rodriguez-Lopez, Mauricio A. Villavicencio, Gus J. Vlahakes, Richard N. Channick, Cameron D. Wright

Abstract

Pulmonary thromboendarterectomy (PTE) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but is a technically challenging operation for cardiothoracic surgeons. Starting a new program allows an opportunity to define a learning curve for PTE. A retrospective case review was performed of 134 consecutive PTEs performed from 1998 to 2016 at a single institution. Outcomes were compared using either a two-tailed t-test for continuous variables or a chi-squared test for categorical variables according to experience of the program by terciles (T). The 30-day mortality was 3.7%. The mean length of hospital stay, length of ICU stay, and duration on a ventilator were 12.6 days, 4.6 days, and 2.0 days, respectively. The mean decrease in systolic pulmonary artery pressure (sPAP) was 41.3 mmHg. Patients with Jamieson type 2 disease had a greater change in mean sPAP than those with type 3 disease (p = 0.039). The mean cardiopulmonary bypass time was 180 min (T1-198 min, T3-159 min, p = <0.001), and the mean circulatory arrest time was 37 min (T1-44 min, T3-31 min, p < 0.001). Plotting circulatory arrest times as a running sum compared to the mean demonstrated 2 inflection points, the first at 22 cases and the second at 95 cases. PTE is a challenging procedure to learn, and good outcomes are a result of a multi-disciplinary effort to optimize case selection, operative performance, and postoperative care. Approximately 20 cases are needed to become proficient in PTE, and nearly 100 cases are required for more efficient clearing of obstructed pulmonary arteries.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 16 100%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 4 25%
Student > Master 2 13%
Researcher 2 13%
Other 1 6%
Student > Postgraduate 1 6%
Other 0 0%
Unknown 6 38%
Readers by discipline Count As %
Medicine and Dentistry 8 50%
Nursing and Health Professions 2 13%
Unknown 6 38%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 December 2017.
All research outputs
#20,458,307
of 23,015,156 outputs
Outputs from Journal of Cardiothoracic Surgery
#933
of 1,244 outputs
Outputs of similar age
#377,608
of 441,975 outputs
Outputs of similar age from Journal of Cardiothoracic Surgery
#14
of 17 outputs
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So far Altmetric has tracked 1,244 research outputs from this source. They receive a mean Attention Score of 2.2. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 17 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.