An Ontology for Cardiothoracic Surgical Education and Clinical Data Analytics

The development of an ontology facilitates the organization of the variety of concepts used to describe different terms in different resources. The proposed ontology will facilitate the study of cardiothoracic surgical education and data analytics in electronic medical records (EMR) with the standard vocabulary

Data Analytics of Electronic Medical Record to Study Racial Diversities in Cardiovascular Diagnosis and Treatment.

The study of precision medicine that measures the effects of social, cultural, and environmental influences on health is essential to improve health outcomes. Race is a social concept used historically to divide, track, control populations, and reinforce social hierarchies. Beyond genetics, race is also a surrogate for other socioeconomic factors affecting patient outcomes. Our data analytics study aims to analyze the Electronic Medical Record (EMR) to study patients of different races in diagnosing and treating Coronary Artery Disease (CAD). We found no race discrepancies at the University of California San Francisco Medical Centers. This study opens several new hypotheses for further research in this crucial field

An Ontology for Cardiothoracic Surgical Education and Clinical Data Analytics.

The development of an ontology facilitates the organization of the variety of concepts used to describe different terms in different resources. The proposed ontology will facilitate the study of cardiothoracic surgical education and data analytics in electronic medical records (EMR) with the standard vocabulary

Midterm Durability and Structural Valve Degeneration of Transcatheter Aortic Valve Replacement in a Federal Facility

ObjectiveTranscatheter aortic valve replacement (TAVR), previously reserved for patients of intermediate to prohibitive surgical risk, has now been expanded to patients of any surgical risk with severe aortic stenosis. Bioprostheses are prone to structural valve degeneration (SVD), a progressive and multifactorial process that limits valve durability. As the population undergoing TAVR shifts toward a lower-risk and younger profile, long-term durability is a crucial determinant for patient outcomes. Our objective was to determine the incidence and risk factors of SVD at midterm follow-up in a veteran TAVR population.MethodsPatients undergoing TAVR at our federal facility were retrospectively evaluated for SVD and other endpoints with standardized consensus criteria. Multivariable Cox proportional hazards analysis was performed to evaluate risk factors for mortality and SVD.ResultsFrom 2013 to 2020, 344 patients (median age, 78 years) underwent TAVR. Survival from all-cause mortality was 91.3% at 1 year, 75.1% at 3 years, and 61.7% at 5 years. Cumulative freedom from SVD was 98.2% at 1 year, 96.5% at 3 years, and 93.7% at 5 years. All 13 patients with SVD met hemodynamic criteria, and 1 required intervention. Median time to hemodynamic SVD was 1.04 years. Independent risk factors for SVD included age (hazard ratio [HR] = 0.92, 95% confidence interval [CI]: 0.86 to 0.99) and valve size (HR = 0.19, 95% CI: 0.04 to 0.89).ConclusionsSVD was evident at a low but detectable rate at 5-year follow-up. Further understanding of TAVR biomechanics as well as continued longer-term follow-up will be essential for informing patient-specific risk of SVD