European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · May 2007
Late coronary artery lesions after neonatal arterial switch operation: results of surgical coronary revascularization.
To evaluate the results of surgical revascularization in children with coronary artery lesions following neonatal arterial switch operation (ASO). ⋯ (1) Following ASO, coronary lesions are not uncommon and they are progressive. Routine and sequential coronary evaluation is necessary. (2) Coronary revascularization can be achieved using coronary angioplasty in most cases. Mammary bypass may be used in selected circumstances. Normal myocardial perfusion is restored in most patients.
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Eur J Cardiothorac Surg · May 2007
Randomized Controlled TrialEffect of preoperative angiotensin converting enzyme inhibitor or angiotensin receptor blocker use on the frequency of atrial fibrillation after cardiac surgery: a cohort study from the atrial fibrillation suppression trials II and III.
Two recent meta-analyses demonstrated that angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) reduce the risk of developing new-onset atrial fibrillation (AF) by nearly 50%. However, the ability of ACEIs or ARBs to prevent postoperative atrial fibrillation (POAF) after cardiac surgery has not been adequately evaluated. ⋯ Although preoperative ACEI or ARB use reduced the odds of developing POAF by 29%, this association with not found to be statistically significant. A study with approximately 600 subjects would be needed to discern if ACEIs or ARBs truly impact POAF.
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Eur J Cardiothorac Surg · May 2007
Comparative StudyAllografts for aortic valve or root replacement: insights from an 18-year single-center prospective follow-up study.
Whether allografts are the biological valve of choice for AVR in non-elderly patients remains a topic of debate. In this light we analyzed our ongoing prospective allograft AVR cohort and compared allograft durability with other biological aortic valve substitutes. ⋯ The use of allografts for AVR is associated with low occurrence rates of most valve-related events, but over time the risk of SVD increases, comparable to stented xenografts. It remains in our institute the preferred valve substitute only for patients with active aortic root endocarditis and for patients in whom anticoagulation should be avoided.
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Eur J Cardiothorac Surg · May 2007
Changes in B-type natriuretic peptides after surgical ventricular restoration.
The aim of this study was to prospectively investigate changes in brain natriuretic peptide (BNP) and amino terminal pro-BNP (NT-pro-BNP) in relation to functional status after surgical ventricular restoration (SVR). ⋯ Heart failure secondary to post-infarction left ventricular remodeling can be reversed by SVR. Improvement in these patients was associated with reduced levels of B-type natriuretic peptides 6 months after surgery. Clinical improvement was maintained and peptide levels were further reduced at late follow-up.
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Eur J Cardiothorac Surg · May 2007
Right ventricular outflow tract obstruction after arterial switch operation for the Taussig-Bing heart.
Incidence of right ventricular outflow tract obstruction (RVOTO) may be suspected to be higher after arterial switch operation (ASO) for Taussig-Bing heart than after ASO for transposition of the great arteries (TGA), as Taussig-Bing anomaly is frequently associated with aortic arch obstruction and subvalvular aortic stenosis. We evaluated the risk to develop RVOTO after ASO for Taussig-Bing heart. ⋯ Postoperative right-sided obstruction occurs more frequently after ASO repair of Taussig-Bing heart than after TGA arterial switching, leading to higher reintervention rate. Resection of the commonly associated subaortic stenosis often prevents RVOTO development.