European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2015
Impact of residual right ventricular outflow tract obstruction on biventricular strain and synchrony in patients after repair of tetralogy of Fallot: a cardiac magnetic resonance feature tracking study.
Residual right ventricular outflow tract (RVOT) obstruction (RVOTO) is considered beneficial in patients after repair of tetralogy of Fallot (TOF) although underlying mechanisms are unknown. We sought to elucidate differences in myocardial strain and dyssynchrony parameters in patients after TOF repair with and without residual RVOTO using cardiovascular magnetic resonance (CMR) feature-tracking (CMR-FT) analysis. ⋯ In patients after TOF repair, residual RVOTO seems to preserve RV strain and results in stronger RV-LV interactions and less interventricular dyssynchrony and may therefore possess an early protective effect on RV remodelling. However, the potential negative impact of residual pulmonary stenosis on LV strain and intraventricular synchrony needs further investigation.
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Eur J Cardiothorac Surg · Jul 2015
Clinical outcomes of combined aortic root reimplantation technique and total arch replacement.
The goal of this study was to evaluate early and late outcomes of combined valve-sparing aortic root replacement and total arch replacement (TAR). ⋯ Early outcomes of combined aortic root reimplantation and TAR were satisfactory and provided excellent freedom from thromboembolic complication. The rate of freedom from reoperation during long-term follow-up was acceptable. Further follow-up is required to evaluate this procedure.
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Eur J Cardiothorac Surg · Jul 2015
Alternative approach for right ventricular failure after left ventricular assist device placement in animal model.
Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. This study was designed to evaluate the effectiveness of an atrial septostomy with a membrane oxygenator incorporated in an LVAD as a novel approach for right ventricular failure after LVAD implantation. ⋯ In the present model of right ventricular failure after LVAD implantation, LVAD flow was significantly increased and haemodynamics improved without compromising systemic oxygenation by the use of an interatrial shunt and a membrane oxygenator incorporated in the LVAD. Our results indicate that this novel approach may be less invasive for a right ventricular failure after LVAD implantation.
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Eur J Cardiothorac Surg · Jul 2015
Robotic thymectomy in patients with myasthenia gravis: neurological and surgical outcomes.
Thymectomy is frequently used in the treatment of myasthenia gravis (MG). But indication, timing or surgical approach remain controversial. This study reports our experiences with robotic thymectomy and surgical and neurological outcomes in a large cohort of patients with MG. ⋯ Robotic thymectomy in patients with MG is safe and feasible. A neurological benefit and decreased use of steroids can be obtained in the majority of patients. No significant difference in neurological outcome was observed as the result of timing of robot thymectomy after the onset of MG.