Journal of cardiac surgery
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Transcatheter closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) with Amplatzer septal/duct occluder (ASO/ADO) is an established, safe, and efficient procedure with high success. However, device embolization remains a major complication requiring immediate intervention (either percutaneous or surgical) for retrieval and correction of the heart defect. The aim of this study is to share the experience of managing embolized ASO/ADO. ⋯ Careful consideration should be given to surgical or transcatheter closure of a heart defect. Life-threatening complications although rare can occur. Our experience strongly suggests that these devices should only be inserted in facilities where cardiac surgical support is immediately available.
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Case Reports
A modified technique of left ventricular restoration: endoventricular spiral plication.
We describe a modified technique of left ventricular restoration after anterior myocardial infarction, referred to as endoventricular spiral plication (ESP). This technique was designed for surgical ventricular restoration with a modified spiral stitch and no patch plasty. A continuous spiral stitch can reconstruct the left ventricular shape both at the short and long axis, and appropriate restoration can be achieved by adjusting the tension of the string and the degree of spiral rotation.
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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiac disorder characterized by replacement of myocytes with adipose and fibrous tissue and often presents with ventricular arrhythmia, heart failure, and sudden death. This report describes a 67-year-old man with ARVC complicated with severe mitral regurgitation, dilated annulus of the tricuspid valve, and coronary artery-pulmonary artery fistula. Mitral valve repair, tricuspid valve annuloplasty, and ligation of the coronary artery-pulmonary artery fistula were performed. The postoperative course was uneventful, and the patient was discharged on postoperative day 15.
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Comparative Study
Assessment of EuroSCORE in patients undergoing aortic valve replacement.
The logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) is a risk stratification system used to predict the operative risk in patients undergoing surgical aortic valve replacement (AVR). The aim of this study is to investigate how accurate this system is, and how it compares to the observed risk. ⋯ The logistic EuroSCORE overestimates the risks for AVR. Therefore, it should not be used to deny high-risk patients a surgical AVR.
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Comparative Study
Strategies and outcomes of cardiac surgery in Jehovah's Witnesses.
Jehovah's Witnesses (JW) are a Christian faith, with an estimated 1.1 million members in the United States, well recognized for their refusal of blood and blood products. JW may not be considered for cardiac surgery due to perceived higher risks of morbidity and mortality. This study reviews our contemporary strategies and experience with JW undergoing routine and complex cardiac surgery. ⋯ Using a multidisciplinary approach to blood management, JW can safely undergo routine and complex cardiac surgery with minimal morbidity and mortality.