Interactive cardiovascular and thoracic surgery
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Favourable outcomes in the repair of Ebstein's anomaly are predicated on tricuspid valve competence, right ventricular function and presence of arrhythmia. We report our experience with a single-stage, three-fold repair of Ebstein's anomaly, namely, cone reconstruction of the tricuspid valve supplemented by bidirectional cavopulmonary anastomosis and right atrial electrocautery maze. ⋯ Single-stage, three-fold repair for the management of Ebstein's anomaly offers good outcome in terms of low mortality and morbidity rates. It can achieve a durable valve-sparing repair, good functional mid-term outcomes and good quality of life among survivors.
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Interact Cardiovasc Thorac Surg · Jan 2017
The extracellular matrix patch implanted in the right ventricle evaluated with cardiovascular magnetic resonance protocol to assess regional physio-mechanical properties.
An extracellular matrix patch was implanted in the porcine right ventricle for in situ myocardial regeneration. A newly developed cardiovascular magnetic resonance protocol was utilized to investigate the regional physio-mechanical function of the patch. ⋯ With the cardiovascular magnetic resonance protocol, we successfully confirmed early signs of functional myocardial regeneration in implanted extracellular matrix patches. This approach is promising in assessing in situ regional physio-mechanical properties and degree of regeneration of implanted tissue-engineered materials.
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Interact Cardiovasc Thorac Surg · Jan 2017
Comparative StudyIs the Ross procedure a riskier operation? Perioperative outcome comparison with mechanical aortic valve replacement in a propensity-matched cohort.
The aim of this study was to compare perioperative outcomes in young adults following isolated Ross procedure versus mechanical aortic valve replacement (AVR) in a high-volume centre. ⋯ There are no differences in mortality or major perioperative outcomes in adults undergoing an isolated Ross procedure or mechanical AVR.
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Interact Cardiovasc Thorac Surg · Jan 2017
Comparative Study Observational StudyTranscatheter valve-in-valve implantation versus redo surgical aortic valve replacement in patients with failed aortic bioprostheses.
Transcatheter aortic valve-in-valve implantation (ViV) is a new treatment for failing bioprostheses (BP) in patients with high surgical risk. However, comparative data, using standard repeat surgical aortic valve replacement (redo-SAVR), are scarce. We compared outcomes after ViV with those after conventional redo-SAVR in two European centres with established interventional programmes. ⋯ Despite a higher risk profile in the ViV group, early mortality rates were not different compared with those of surgery. Although ViV resulted in elevated transvalvular gradients and therefore a lower rate of device success, mortality rates were similar to those with redo-SAVR. At present, both techniques serve as complementary approaches, and allow individualized patient care with excellent outcomes.
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Interact Cardiovasc Thorac Surg · Dec 2016
Observational StudyClinical outcomes and direct costs after transcatheter aortic valve implantation in French centres: a longitudinal study of 1332 patients using a national database.
To describe the clinical outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) and to determine the direct costs before and after TAVI. ⋯ Mortality at 3 years is consistent with other published studies. After TAVI, hospitalization stays in both acute and rehabilitation settings, and the associated costs do not appear to be reduced compared with the year preceding TAVI. The total cost for patients undergoing TAVI is substantial at 3 years.