The Annals of thoracic surgery
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The effect of prosthesis-patient mismatch on long-term survival after mitral valve replacement (MVR) has received limited attention. This study was performed to determine the predictors of mortality after MVR and influence of prosthesis-patient mismatch on survival. ⋯ Prosthesis-patient mismatch is not a predictor of overall mortality to 15 years after MVR regardless of the category of effective orifice area index. The preoperative variable, pulmonary hypertension, influences overall mortality in the presence of mild-to-moderate and severe prosthesis-patient mismatch in the survival analysis.
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At our institution, coronary artery bypass grafting (CABG) operations are performed by staff surgeons or by first- or second-year cardiothoracic residents under the direct supervision of attending surgeons. We evaluated the influence of surgical seniority on outcomes. ⋯ Lower academic seniority was associated with longer CABG operative times but did not affect outcomes. Thus, training residents to perform CABG is safe and is characterized by progressive improvement in their technical efficiency.
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Case Reports
Repair of mitral valve and left atrioventricular disruption caused by blunt chest trauma.
We describe a case of acute cardiac failure in a patient involved in a motor vehicle accident. A diagnosis of acute mitral regurgitation and left atrioventricular disruption was made with transesophageal echocardiography. Successful repair was performed using the mitral valve leaflets to patch the disruption followed by valve replacement.
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The Ley prosthesis is a titanium plate, which has been used in the past few years for sternum stabilization after postoperative mediastinitis and sternal dehiscence. There is no previous description of the use of this device in chest wall reconstruction after tumor resection. We describe the surgical technique for reconstruction of the skeletal defects with the Ley prosthesis in 3 patients operated on for a sternal chondrosarcoma. We propose the application of the Ley prosthesis for optimal reconstruction of skeletal tissue after sternal resection.