European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2011
Multicenter StudyOutcome after surgery for acute aortic dissection type A in patients over 70 years: data analysis from the German Registry for Acute Aortic Dissection Type A (GERAADA).
The number of elderly patients undergoing emergency surgery for acute aortic dissection type A (AADA) is rising. Published results report a higher risk for these patients compared with younger patients. The aim of our study was to analyse the surgical outcome of these patients and to identify those at risk. ⋯ Emergency surgery for septuagenarians with acute aortic dissection type A (AADA) resulted in acceptable mortality. Octogenarians revealed significantly higher 30-day mortality (odds ratio (OR)=3.23, confidence interval (CI)=(1.81-5.72)), although it was lower than the mortality among patients without surgical treatment. A surgical approach should be considered in all patients on an individual basis.
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Eur J Cardiothorac Surg · Aug 2011
Meta AnalysisSystematic evaluation of the flexible and rigid annuloplasty ring after mitral valve repair for mitral regurgitation.
Mitral annulus reconstruction is now a common surgical procedure for the treatment of mitral regurgitation. However, there are still controversies in the selection of materials for annuloplasty in the clinical controlled studies available. The purpose of the present systematic review of the literature is to address whether a flexible ring is superior to a rigid ring in terms of improvement in clinical and echocardiographic outcomes. ⋯ Except for the improvement in ejection fraction and preserving the mitral valve area effects in the flexible cases, it remains comparable with regard to overall survival, mortality, reoperation, regurgitant recurrence, and left ventricular performance between the flexible and rigid ring.
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Eur J Cardiothorac Surg · Aug 2011
Conventional aortic valve replacement in patients with concomitant coronary artery disease and previous coronary artery bypass grafting in the era of interventional approaches.
In patients with symptomatic aortic valve stenosis and a high estimated operative risk due to previous coronary artery bypass grafting (CABG) procedures, interventional aortic valve implantation techniques may ultimately prove superior. However, recent studies have revealed increased mortality and impaired survival in patients with concomitant coronary artery disease (CAD). ⋯ Conventional surgery in patients with symptomatic aortic valve stenosis after previous CABG can be performed with excellent results despite a high calculated risk, independent of age. Although conventional surgery is technically more demanding and associated with substantial surgical trauma, it is justified by the excellent survival and high quality of life in this high-risk patient cohort.
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Eur J Cardiothorac Surg · Aug 2011
Midterm outcome after aortic root replacement with stentless porcine bioprostheses.
Midterm clinical outcome was evaluated after aortic root replacement with Freestyle® stentless aortic root bioprostheses. ⋯ Aortic root replacement with the stentless Freestyle® bioprosthesis provided a respectable short-term mortality, optimal valve durability and acceptable rates of valve-related complications within 9 years.