Journal of cardiac surgery
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To examine hospital resources associated with patient outcomes for aortic valve replacement (AVR), including inpatient adverse events and mortality. ⋯ The volume-outcomes relationship was associated with mortality outcomes but not postoperative complications. We identified structural differences in hospital size, nurses-to-patient ratio, and nursing skill level indicative of high quality outcomes.
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The aim of this study is to evaluate acute kidney injury (AKI) after total aortic arch repair (TAR) with moderate hypothermic circulatory arrest (MHCA) and selective antegrade cerebral perfusion (SACP). ⋯ Postoperative AKI stratified by RIFLE criteria was significantly associated with short- and mid-term outcomes in TAR with MHCA and SACP.
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Vascular laceration is a rare but potentially fatal complication with excimer laser-assisted pacemaker or implantable cardioverter-defibrillator lead extraction. We report our experience on management of vascular laceration during laser-assisted lead extraction. ⋯ Cardiopulmonary bypass standby is helpful when performing laser-assisted lead extraction to treat potentially fatal vascular laceration. Dual-coil lead is an independent risk factor to predict intraoperative vascular laceration.
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Minimally invasive perventricular closure is emerging as an alternative to conventional open surgery in treating traumatic ventricular septal defects (VSDs). We report a case of successful perventricular closure of a post-traumatic muscular VSD in a patient who sustained blunt chest trauma in a motor vehicle accident. A larger Amplatzer muscular VSD occluder (16 mm in diameter) was used to close the VSD near the apex.
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A 36-year-old intravenous drug abuser presented with an aortic root abscess and partial rupture of the posteromedial papillary muscle. Following aortic and mitral valve replacement, histological and microbiological analysis of the papillary muscle demonstrated methicillin-sensitive Staphylococcus aureus infection.