The Annals of thoracic surgery
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Comparative Study
Effect of coronary artery disease extent on contemporary outcomes of combined aortic valve replacement and coronary artery bypass graft surgery.
Concomitant aortic valve replacement (AVR) and coronary artery bypass graft surgery (CABG) is a common procedure. Whether the extent of coronary artery disease (CAD) influences outcomes of AVR plus CABG is unknown. ⋯ Compared with AVR plus CABG for one- or two-vessel CAD, AVR plus CABG for left main or three or more vessel CAD had higher observed and risk-adjusted rates of postoperative complications but not operative or 1-year mortality.
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Comparative Study
Minimally invasive mitral valve surgery: influence of aortic clamping technique on early outcomes.
Several methods of aortic clamping have been described for minimally invasive mitral valve surgery (MIMVS). The aim of this study was to compare the endoaortic balloon occlusion technique with the transthoracic clamp approach in terms of perioperative outcomes. ⋯ Minimally invasive mitral valve surgery can be performed successfully using either the endoaortic balloon technique or the transthoracic clamp approach. However, the transthoracic technique results in shorter operation time, less perioperative bleeding and better myocardial protection.
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Case Reports
Intermittent tethering of second-order chords after mitral valve repair for bileaflet prolapse.
Mitral valve regurgitation which occurs immediately after repair can be due to anatomic (failure of repair) or functional (systolic anterior motion) reasons. We report a case where a patient with bileaflet prolapse showed, after surgical correction of the disease, moderate to severe regurgitation after cardiopulmonary bypass was stopped. The regurgitation was due to second-order tethering and was successfully treated with second-order chordal cutting.
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Giant coronary artery aneurysm with a fistula is a rare condition. We present one of the largest aneurysms of left circumflex coronary artery territory, arising from the left atrial branch of the left circumflex coronary artery. ⋯ Total exclusion of the aneurysmal mass was achieved by ligation of the afferent artery, closure of the entry point from within the aneurysm, and closure of the fistulous communication from within the right atrium. The patient's postoperative course was uneventful.