Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Sep 2019
Meta AnalysisReported outcomes after aortic valve resuspension for acute type A aortic dissection: a systematic review and meta-analysis.
In the majority of patients presenting with acute type A aortic dissection (AAD) complicated by aortic valve insufficiency, the aortic valve (AV) can be preserved by AV resuspension. A meta-analysis was performed to investigate the outcomes following AV resuspension for AAD. A systematic literature search for publications reporting outcomes after AV resuspension in AAD published between January 1998 and June 2018 was conducted. ⋯ The long-term durability of AV resuspension is excellent, with low rates of endocarditis and thromboembolism and bleeding. Root reoperation hazard has become acceptable in recent years. Preoperative aortic valve insufficiency grade exceeding 2+ is a predictor for root reoperation.
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Interact Cardiovasc Thorac Surg · Sep 2019
Comparative StudyMechanical versus biological valve prosthesis for surgical aortic valve replacement in patients with infective endocarditis.
The optimal choice of valve prosthesis in surgical aortic valve replacement for infective endocarditis (IE) is controversial. We studied outcomes after mechanical versus biological prosthetic valve surgical aortic valve replacement in IE patients. ⋯ The use of mechanical aortic valve is associated with lower mid-term mortality compared to biological prosthesis in patients with native-valve IE aged ≤70 years. Our results do not support the routine choice of a biological aortic valve prosthesis in this patient group.
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Interact Cardiovasc Thorac Surg · Sep 2019
A 45-year experience with the Fontan procedure: tachyarrhythmia, an important sign for adverse outcome.
This study aims to evaluate our 45-year experience with the Fontan procedure and to identify risk factors for late mortality and morbidity. ⋯ With modern techniques, survival and freedom from Fontan failure are good. However, Fontan patients remain subject to general attrition. Tachyarrhythmia is an important sign for an adverse outcome. Prevention and early treatment of tachyarrhythmia may, therefore, be paramount in improving the long-term outcome.
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Interact Cardiovasc Thorac Surg · Sep 2019
Postoperative atrial fibrillation after aortic valve replacement is a risk factor for long-term atrial fibrillation.
Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. However, knowledge on the rate of long-term atrial fibrillation (LTAF) after POAF remains unclear. We investigated predictors of POAF in patients with aortic stenosis undergoing surgical aortic valve replacement, and assessed the rate of LTAF during follow-up. ⋯ ClinicalTrials.gov (NCT02316587).
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Interact Cardiovasc Thorac Surg · Sep 2019
Adding tricuspid repair to standard open heart surgery does not increase risk but improves right ventricular function.
To evaluate outcome of concomitant tricuspid annuloplasty in mild or moderate regurgitation on perioperative outcome and on right ventricular function in patients undergoing major cardiac surgery. ⋯ Adding tricuspid valve repair in patients with mild or moderate secondary TR with a dilated annulus (≥40 mm or >21 mm/m2) to standard open heart surgery does not increase perioperative risk but improves right ventricular function. Therefore, standard tricuspid repair in this subgroup might be considered on a routine basis.