The Annals of thoracic surgery
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Comparative Study
Mechanical Versus Biologic Prostheses for Surgical Aortic Valve Replacement in Patients Aged 50 to 70.
The use of biologic prosthesis is increasing in surgical aortic valve replacement (SAVR). Recent US guidelines recommend either biologic or mechanical prosthesis for SAVR in patients aged 50 to 70 years. We set out to study long-term outcomes of mechanical versus biologic prosthetic valves in this patient group. ⋯ Mechanical valve prostheses were associated with lower mortality, lower rates of reoperation, and lower occurrence of infective endocarditis compared with bioprostheses within 10 years after SAVR in matched patients aged 50 to 70 years. Our results do not support the routine use of biologic valve prostheses in this patient group.
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Comparative Study
Impact of supra-aortic intimal tears on aortic diameter changes after non-total arch replacement.
This study evaluated the impact of the intimal tear location on aortic dilation and reintervention after nontotal arch replacement (non-TAR) for acute type I aortic dissection. ⋯ We confirmed that SA and proximal DTA intimal tears are associated with subsequent aortic dilation and reintervention. These proximal aortic intimal tears might warrant aggressive surgical treatment at the initial operation or close postoperative follow-up.
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Pragmatic Clinical Trial
Prospective Evaluation of a Blood Transfusion Protocol for Patients Undergoing Cardiac Operations.
The Society of Thoracic Surgeons clinical practice guidelines recommend the creation of an interdisciplinary blood management team to implement protocols for improved blood transfusion practices. We report our center's prospective evaluation of a blood transfusion protocol. ⋯ During a prospective evaluation of blood transfusion protocols, a risk-adjusted analysis demonstrated a reduction in transfusions despite poor protocol compliance.
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Contemporary experiences regarding childhood hypertrophic obstructive cardiomyopathy are limited. This study aimed to describe the clinical presentation of childhood hypertrophic obstructive cardiomyopathy and its relevant surgical outcome. ⋯ In our cohort of children with hypertrophic obstructive cardiomyopathy undergoing septal myectomy, biventricular obstruction, myocardial bridging, and intraventricular anatomic abnormalities are frequent phenotypic components. Despite the complexity of childhood hypertrophic obstructive cardiomyopathy, surgical treatment results in a favorable outcome in carefully selected patients.