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 2015
Dilated left atrium as a predictor of late outcome after pulmonary vein isolation concomitant with aortic valve replacement and/or coronary artery bypass grafting†.
Left atrial (LA) dimension can predict atrial fibrillation (AF) recurrence after catheter-based or surgical ablation. Pulmonary vein isolation (PVI) may be a surgical option during aortic valve replacement (AVR) and/or coronary artery bypass grafting (CABG), though consensus regarding patient selection and late outcome is lacking. ⋯ In patients with paroxysmal AF related to aortic valve disease and/or coronary artery disease, a dilated left atrium (≥45 mm) was associated with inferior AF- and event-free survival after PVI, accompanied by persistent abnormalities in cardiac and haemodynamic function. These findings may assist patient selection for PVI during AVR and/or CABG.
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Eur J Cardiothorac Surg · Nov 2015
Results of heart transplantation following failed staged palliation of hypoplastic left heart syndrome and related single ventricle anomalies.
Multistage palliation is the mainstay management strategy of children with hypoplastic left heart syndrome (HLHS) and related single ventricle anomalies. If this palliation strategy fails, heart transplantation (HT) is required. The results of HT in children who had a prior Norwood operation are reportedly poor due to several immune, clinical and anatomical risk factors. We report our institutional outcomes following HT in children who had a prior Norwood operation. ⋯ Children failing multistage palliation of HLHS may require HT, often following the Glenn operation. HT results in this group are comparable with those in other children with congenital heart disease. Improvements in pretransplant management, immune suppression and outpatient care in the later era might have specifically benefited this particularly risky group of patients.
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Eur J Cardiothorac Surg · Nov 2015
Predictive factors of myasthenic crisis after extended thymectomy for patients with myasthenia gravis.
Postoperative myasthenic crisis (POMC) is one of the serious complications after extended thymectomy for patients with myasthenia gravis (MG). This study aims to clarify the risk factors of POMC occurrence. ⋯ POMC occurred more frequently in unstable MG before surgery or in patients with a history of MC. Adequate preoperative medical therapy and perioperative care should be provided to these patients.