The Annals of thoracic surgery
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Randomized Controlled Trial Clinical Trial
High-dose aprotinin reduces activation of hemostasis, allogeneic blood requirement, and duration of postoperative ventilation in pediatric cardiac surgery.
Though multiple studies have affirmed the effectiveness of aprotinin in reducing blood loss in adult cardiac surgery, the possible benefit in pediatric cardiac surgery is controversial. ⋯ High-dose aprotinin effectively attenuated hemostatic activation and reduced blood loss and transfusion requirement in pediatric cardiac surgery. Postoperative ventilation was also shortened in the aprotinin group.
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This study was conducted to evaluate surgical outcome and to identify risk factors for hospital mortality and reoperation after repair of complete atrioventricular septal defect. ⋯ The presence of a double orifice atrioventricular valve emerged as an unforeseen risk factor for death.
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Pulmonary ventricle (PV) to pulmonary artery (PA) conduits have made possible the correction of many complex congenital cardiac anomalies. ⋯ Operations that include conduit placement and replacement can be performed with low early mortality. Younger age at operation was associated with improved late survival. The diagnosis of TGA was associated with increased risk for conduit failure, and the durability of the homograft, in this series, was inferior to the porcine-valved Dacron conduit. Quality of life was excellent for most patients despite the need for reoperation.
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Successful treatment of destructive aortic valve endocarditis with annular abscess formation requires extensive surgical debridement and reconstruction of the left ventricular outflow tract and aortic root. Homograft aortic roots are the conduits of choice, but because they are not available in all cases, alternative conduits are needed. ⋯ The Freestyle aortic root appears to be an acceptable alternative to homografts in the treatment of severe endocarditis. Long-term valve durability in younger patients, however, remains to be determined.
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The valved stentless composite graft has become well established in our hospital for replacement of the ascending aorta and aortic valve in elderly patients and those with contraindication for lifelong anticoagulation. This study was conducted to evaluate the postoperative hemodynamic characteristics and clinical outcomes after implantation of this device. ⋯ A stentless composite graft for replacement of the aortic valve and ascending aorta offers excellent hemodynamic results and is a suitable device for patients in whom anticoagulation should be avoided.