The Annals of thoracic surgery
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Case Reports
Impingement of Single-Tilting Disc Mitral Prosthesis During Transcatheter Aortic Valve Replacement.
An 80-year-old woman with a medical history of mitral valve replacement with single-tilting disc prosthesis underwent transcatheter aortic valve replacement (TAVR). The tilting disc was noted to have abnormal motion after re-ballooning of the TAVR valve. ⋯ After removal of the TAVR valve, the tilting disc moved freely. Although TAVR in patients with mitral prostheses is technically feasible, particular caution is necessary, and postdeployment dilation should be avoided.
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The art and science of outcomes analysis, quality improvement, and patient safety continue to evolve, and cardiothoracic surgery leads many of these advances. The Society of Thoracic Surgeons (STS) National Database is one of the principal reasons for this leadership role, as it provides a platform for the generation of knowledge in all of these domains. ⋯ Therefore, beginning in January 2016, The Annals of Thoracic Surgery began publishing a monthly series of scholarly articles on outcomes analysis, quality improvement, and patient safety. This article provides a summary of the status of the STS National Database as of October 2016 and summarizes the articles about the STS National Database that appeared in The Annals of Thoracic Surgery 2016 series, "Outcomes Analysis, Quality Improvement, and Patient Safety."
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Multicenter data regarding the around-the-clock (24/7) presence of an in-house critical care attending physician with outcomes in children undergoing cardiac operations are limited. ⋯ The presence of 24-hour in-ICU attending physician coverage in children undergoing cardiac operations is associated with improved outcomes, including ICU mortality. It is possible that 24-hour in-ICU attending physician coverage may be a surrogate for other factors that may bias the results. Further study is warranted.
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Case Reports
Ascending Aortic Replacement and Sutureless Valve in a Failed Stentless Aortic Prosthesis: A Bailout Option.
Aortic valve replacement with a Perceval sutureless bioprosthesis is a viable rescue option for a failed aortic stentless prosthesis. However, a dilated sinotubular junction and ascending aorta are reported as a contraindication for this technique. We describe an aortic sutureless valve implantation in a patient with a dilated ascending aorta and small aortic root after Dacron graft replacement of the ascending aorta in a failed aortic stentless bioprosthesis.