Does Tweeting Improve Citations? One-Year Results From the TSSMN Prospective Randomized Trial.

BACKGROUND: The Thoracic Surgery Social Media Network (TSSMN) is a collaborative effort of leading journals in cardiothoracic surgery to highlight publications via social media. This study aims to evaluate the 1-year results of a prospective randomized social media trial to determine the effect of tweeting on subsequent citations and nontraditional bibliometrics. METHODS: A total of 112 representative original articles were randomized 1:1 to be tweeted via TSSMN or a control (non-tweeted) group. Measured endpoints included citations at 1 year compared with baseline, as well as article-level metrics (Altmetric score) and Twitter analytics. Independent predictors of citations were identified through univariable and multivariable regression analyses. RESULTS: When compared with control articles, tweeted articles achieved significantly greater increase in Altmetric scores (Tweeted 9.4 ± 5.8 vs Non-tweeted 1.0 ± 1.8, P < .001), Altmetric score percentiles relative to articles of similar age from each respective journal (Tweeted 76.0 ± 9.1 percentile vs Non-tweeted 13.8 ± 22.7 percentile, P < .001), with greater change in citations at 1 year (Tweeted +3.1 ± 2.4 vs Non-Tweeted +0.7 ± 1.3, P < .001). Multivariable analysis showed that independent predictors of citations were randomization to tweeting (odds ratio [OR] 9.50; 95% confidence interval [CI] 3.30-27.35, P < .001), Altmetric score (OR 1.32; 95% CI 1.15-1.50, P < .001), open-access status (OR 1.56; 95% CI 1.21-1.78, P < .001), and exposure to a larger number of Twitter followers as quantified by impressions (OR 1.30, 95% CI 1.10-1.49, P < .001). CONCLUSIONS: One-year follow-up of this TSSMN prospective randomized trial importantly demonstrates that tweeting results in significantly more article citations over time, highlighting the durable scholarly impact of social media activity.

Social Media Improves Cardiothoracic Surgery Literature Dissemination: Results of a Randomized Trial.

BACKGROUND: The Thoracic Surgery Social Media Network (TSSMN) represents a collaborative effort of leading journals in cardiothoracic surgery to highlight publications via social media, specifically Twitter. We conducted a prospective randomized trial to determine the effect of scheduled tweeting on nontraditional bibliometrics of dissemination. METHODS: A total of 112 representative original articles (2017-2018) were selected and randomized 1:1 to an intervention group to be tweeted via TSSMN or a control (non-tweeted) group. Four articles per day were tweeted by TSSMN delegates for 14 days. Primary endpoints included change in article-level metrics (Altmetric) score pre-tweet and post-tweet compared with the control group. Secondary endpoints included change in Twitter analytics day 1 post-tweet and day 7 post-tweet for each article compared with baseline. RESULTS: Tweeting via TSSMN significantly improved article Altmetric scores (pre-tweet 1 vs post-tweet 8; P < .001), Mendeley reads (pre-tweet 1 vs post-tweet 3; P < .001), and Twitter impressions (day 1 post-tweet 1599 vs day 7 post-tweet 2296; P < .001). Subgroup analysis demonstrates that incorporating photos into the tweets trended toward increased link clicks to the full-text article (P = .08) whereas tweeting at 1 pm Eastern Standard Time and 9 pm Eastern Standard Time generated the highest and lowest audience reach (P = .022), respectively. Articles published in adult cardiac surgery achieved the highest change in Altmetric score (P = .028) and Mendeley reads (P = .028), and were more likely to be retweeted (P = .042) than were those published on education, general thoracic surgery, and congenital surgery. CONCLUSIONS: Social media highlights of scholarly literature via TSSMN Twitter activity improves article Altmetric scores, Mendeley reads, and Twitter analytics, with dissemination to a greater audience.

The Thoracic Surgery Social Media Network: Early Experience and Lessons Learned.

BACKGROUND: The Thoracic Surgery Social Media Network (TSSMN) is a social media collaborative formed in 2015 by The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery to bring social media attention to key publications from both journals and to highlight major accomplishments in the specialty. Our aim is to describe TSSMN's preliminary experience and lessons learned. METHODS: Twitter analytics was used to obtain information regarding the @TSSMN Twitter handle and #TSSMN hashtag. TweetChat and general hashtag #TSSMN analytics were measured using Symplur (Symplur LLC, Los Angeles, CA). A TSSMN Tweeter App was created, and its use and downloads were analyzed. RESULTS: Hashtag #TSSMN has a total of 17,181 tweets, 2,100 users, and 32,226,280 impressions, with peaks in tweeting activity corresponding to TweetChats. Thirteen 1-hour TweetChats drew a total of 489 participants, 5195 total tweets, and 17,297,708 total impressions. The top demographic category of TweetChat participants included Doctors (47%), Advocates/Supports (11%), and Unknown (10%), with 3% characterized as patients. The TSSMN Tweeter iTunes App (Apple, Cupertino, CA) was downloaded 3319 times with global representation. A total of 859 articles were viewed through the App, with 450 articles from The Annals of Thoracic Surgery and 409 from The Journal of Thoracic and Cardiovascular Surgery. CONCLUSIONS: We demonstrate that TSSMN further enhances the ability for the journals to connect with their readership and the cardiothoracic community. Ongoing studies to correlate social media attention with article reads, article-level metrics, citations, and journal impact factor are eagerly awaited.

The Thoracic Surgery Social Media Network: Early experience and lessons learned.

BACKGROUND: The Thoracic Surgery Social Media Network (TSSMN) is a social media collaborative formed in 2015 by The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery to bring social media attention to key publications from both journals and to highlight major accomplishments in the specialty. Our aim is to describe TSSMN's preliminary experience and lessons learned. METHODS: Twitter analytics was used to obtain information regarding the @TSSMN Twitter handle and #TSSMN hashtag. TweetChat and general hashtag #TSSMN analytics were measured using Symplur (Symplur LLC, Los Angeles, Calif). A TSSMN Tweeter App was created, and its use and downloads were analyzed. RESULTS: Hashtag #TSSMN has a total of 17,181 tweets, 2100 users, and 32,226,280 impressions, with peaks in tweeting activity corresponding to TweetChats. Thirteen 1-hour TweetChats drew a total of 489 participants, 5195 total tweets, and 17,297,708 total impressions. The top demographic category of TweetChat participants included Doctors (47%), Advocates/Supports (11%), and Unknown (10%), with 3% characterized as patients. The TSSMN Tweeter iTunes App (Apple, Cupertino, Calif) was downloaded 3319 times with global representation. A total of 859 articles were viewed through the App, with 450 articles from The Annals of Thoracic Surgery and 409 from The Journal of Thoracic and Cardiovascular Surgery. CONCLUSIONS: We demonstrate that TSSMN further enhances the ability for the journals to connect with their readership and the cardiothoracic community. Ongoing studies to correlate social media attention with article reads, article-level metrics, citations, and journal impact factor are eagerly awaited.

Pump thrombosis-A riddle wrapped in a mystery inside an enigma.

This manuscript reviews the state of the art regarding the subject of pump thrombosis (PT). The historical context of PT and the clinical data are described, the etiologic factors are elucidated, preventive strategies are explored, diagnostic modalities are reviewed, and management principles are defined. There clearly remains much work to be done towards solving this riddle wrapped in a mystery inside an enigma, but promising foundations are being established.

Coronary artery bypass grafting vs percutaneous coronary intervention and long-term mortality and morbidity in multivessel disease: meta-analysis of randomized clinical trials of the arterial grafting and stenting era.

IMPORTANCE: Recent trials of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) for multivessel disease were not designed to detect a difference in mortality and therefore were underpowered for this outcome. Consequently, the comparative effects of these 2 revascularization methods on long-term mortality are still unclear. In the absence of solid evidence for mortality difference, PCI is oftentimes preferred over CABG in these patients, given its less invasive nature. OBJECTIVES: To determine the comparative effects of CABG vs PCI on long-term mortality and morbidity by performing a meta-analysis of all randomized clinical trials of the current era that compared the 2 treatment techniques in patients with multivessel disease. DATA SOURCES: A systematic literature search was conducted for all randomized clinical trials directly comparing CABG with PCI. STUDY SELECTION: To reflect current practice, we included randomized trials with 1 or more arterial grafts used in at least 90%, and 1 or more stents used in at least 70% of the cases that reported outcomes in patients with multivessel disease. DATA EXTRACTION: Numbers of events at the longest possible follow-up and sample sizes were extracted. DATA SYNTHESIS: A total of 6 randomized trials enrolling a total of 6055 patients were included, with a weighted average follow-up of 4.1 years. There was a significant reduction in total mortality with CABG compared with PCI (I2 = 0%; risk ratio [RR], 0.73 [95% CI, 0.62-0.86]) (P < .001). There were also significant reductions in myocardial infarction (I2 = 8.02%; RR, 0.58 [95% CI, 0.48-0.72]) (P < .001) and repeat revascularization (I2 = 75.6%; RR, 0.29 [95% CI, 0.21-0.41]) (P < .001) with CABG. There was a trend toward excess strokes with CABG (I2 = 24.9%; RR, 1.36 [95% CI, 0.99-1.86]), but this was not statistically significant (P = .06). For reduction in total mortality, there was no heterogeneity between trials that were limited to and not limited to patients with diabetes or whether stents were drug eluting or not. Owing to lack of individual patient-level data, additional subgroup analyses could not be performed. CONCLUSIONS AND RELEVANCE: In patients with multivessel coronary disease, compared with PCI, CABG leads to an unequivocal reduction in long-term mortality and myocardial infarctions and to reductions in repeat revascularizations, regardless of whether patients are diabetic or not. These findings have implications for management of such patients.

Harvesting the radial artery.

The radial artery (RA) has emerged as an important arterial graft for coronary bypass surgery. With improving five-year patency rates and increasing uptake, great attention has been focused on the optimal conduit harvesting technique. We herein present our approach to RA harvesting. Prerequisites of a successful harvest include adherence to important anatomical landmarks, protection of the sensory innervation to the volar forearm, and meticulous handling of the RA branches. Regardless of the harvesting methodology chosen, adherence to a "no-touch" technique will optimize the patency and durability of the RA conduit.

Erosion of an Amplatzer septal occluder device into the aortic root.

Atrial septal defects can be closed surgically or percutaneously. We report a patient who underwent percutaneous closure of an atrial septal defect with an Amplatzer septal occluder device (AGA Medical Corp, Golden Valley, MN). The patient presented 4 months later with congestive heart failure secondary to an erosion of the Amplatzer septal occluder into the aortic root. The device was removed surgically, and the fistula was repaired. Amplatzer septal occluder indications, selection criteria, and complications are discussed.

Cardiac papillary fibroelastoma mimicking left atrial appendage thrombus.

A 76-year-old woman was admitted with suggested cardioembolism. Transesophageal echocardiogram revealed a large, highly mobile mass within a dynamic left atrial appendage that was confirmed by computed tomography to be prolapsing into the body of the left atrium. A multilobulated, pedunculated fibroelastoma was resected at surgery.

Surgical management of ascending aortic disease.

Two cases of aortic pathology have been presented--namely, ascending aortic aneurysm and ascending aortic dissection. These entities are distinct, but can be superimposed. Surgical resection is the procedure of choice for both these entities, in contradistinction to descending aortic dissections. Although dealing with these entities can indeed be a humbling experience, lifesaving treatment can be delivered by a combination of a high index of suspicion, early diagnosis, and prompt surgical therapy.