European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2014
Bilateral internal thoracic artery use in patients with low ejection fraction: is there any additional long-term benefit?
The use of bilateral internal thoracic arteries (BITA) has been associated with improved long-term outcomes following coronary artery bypass graft (CABG) surgery. The objective of this study was to evaluate the impact of BITA use on long-term survival among patients with low ejection fraction (EF) undergoing CABG. ⋯ The use of a second internal thoracic artery (ITA) does not prolong late survival in patients with low EF undergoing CABG compared with a propensity-matched group of SITA graft patients.
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Eur J Cardiothorac Surg · Sep 2014
Comparative StudyComparison of the Ross/Ross-Konno aortic root in children before and after the age of 18 months.
Evaluation of long-term results after the Ross/Ross-Konno operation in patients <18 months of age, focusing on pulmonary autograft performance. ⋯ Ross/Ross-Konno can be invaluable in the younger age group but not without risk in the setting of ventricular dysfunction. Long-term performance of the neoaortic valve is significantly better than in older children, which is related to maintenance of normal root dimensions compared with progressive dilatation in patients undergoing Ross/Ross-Konno at older ages.
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Eur J Cardiothorac Surg · Sep 2014
Reoperation for neoaortic root pathology after the arterial switch operation.
To evaluate incidence and results of surgical intervention for neoaortic root pathology following arterial switch operation (ASO) for transposition of the great arteries (TGA). ⋯ After ASO, surgery for neoaortic root pathology may become necessary when follow-up is long enough and regardless of primary diagnosis or other risk factors. Redo neoaortic surgery can be performed with low risk taking into account the specific technical difficulties.
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Eur J Cardiothorac Surg · Sep 2014
High-emergency waiting list for lung transplantation: early results of a nation-based study.
The high mortality rate observed on the regular waiting list (RWL) before lung transplantation (LTx) prompted the French organ transplantation authorities to set up in 2007 a dedicated graft allocation strategy, the so-called 'high-emergency waiting list' (HEWL), for patients with an abrupt worsening of their respiratory function. This study reports on the early results of this new allocation system. ⋯ The new allocation system aimed at lowering mortality on the RWL, but also offered an access to LTx for new patients with end-stage respiratory failure. The HEWL increased the likelihood of mortality after LTx, but permitted acceptable mid-term survival rates. The high mortality associated with the use of ECMO should be interpreted cautiously.
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Eur J Cardiothorac Surg · Sep 2014
Clinical TrialPreoperative patient optimization using extracorporeal life support improves outcomes of INTERMACS Level I patients receiving a permanent ventricular assist device.
Interagency Registry for Mechanical Assisted Circulatory Support (INTERMACS) Level I patients have the highest early mortality after ventricular assist device (VAD) implantation. This is determined by the exposure of patients in shock with acutely damaged end-organs and high catecholamine support to a significant surgical trauma. We report our experience with a bridge-to-bridge concept consisting of initial veno-arterial extracorporeal life support (ECLS) and deferral of VAD implantation to recovery of end-organ function in INTERMACS Level I patients. ⋯ Preoperative patient optimization using ECLS improves outcomes of INTERMACS Level I patients receiving a permanent VAD.