European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2011
Frozen elephant trunk technique and partial remodeling for acute type A aortic dissection.
The aimed to describe the frozen elephant trunk (FET) technique and partial remodeling (PR) for acute type A aortic dissection (ATAAD), considering the long-term prognosis on the basis of our 13 years of experience. ⋯ FET and modified PR techniques could be effective for improving the long-term outcome on the distal and proximal aorta in an ATAAD.
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Eur J Cardiothorac Surg · Nov 2011
Comparative StudyComparison of aortic root replacement in patients with Marfan syndrome.
Although the aortic-valve-sparing (AVS) reimplantation technique according to David has shown favorable durability results in mid-term and long-term studies, composite valve grafting (CVG) according to Bentall is still considered the standard procedure. ⋯ The reimplantation technique according to David was associated with excellent survival, good valve function and a low rate of re-operation, endocarditis, and stroke. There was a trend to better event-free survival for AVS patients making it the procedure of choice in MFS patients.
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Eur J Cardiothorac Surg · Nov 2011
Re-operations on the proximal thoracic aorta: results and predictors of short- and long-term mortality in a series of 174 patients.
The aim of this study was to report results and to identify predictors of hospital and long-term mortality in patients undergoing re-operations on the proximal thoracic aorta. ⋯ Short- and long-term survival was satisfactory being excellent in patients with degenerative aneurysms and dismal in those with active endocarditis. Extensive aortic resections did not increase hospital mortality and were associated with a reduced need for aortic re-interventions. CPB time remains the most important risk factor for reduced survival in aortic surgery.
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Eur J Cardiothorac Surg · Nov 2011
Meta AnalysisAortic valve replacement for aortic stenosis in patients with concomitant mitral regurgitation: should the mitral valve be dealt with?
Co-existent mitral regurgitation may adversely influence both morbidity and mortality in patients undergoing aortic valve replacement for severe aortic stenosis. Whilst it is accepted that concomitant mitral intervention is required in severe, symptomatic mitral regurgitation, in cases of mild-moderate non-structural mitral regurgitation, improvement may be seen following aortic valve replacement alone, avoiding the increased risk of double-valve surgery. The exact benefit of such a conservative approach is, however, yet to be adequately quantified. ⋯ No significant change was seen in left-ventricular end-systolic diameter (p=0.10), septal thickness (p=0.17) or left atrial area (p=0.23). We conclude that despite reverse remodelling, concomitant moderate-severe mitral regurgitation adversely affects both early and late mortality following aortic valve replacement. Concomitant mitral intervention should therefore be considered in the presence of moderate mitral regurgitation, independent of the aetiology.