The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Comparative StudyImpact of early surgery in the active phase on long-term outcomes in left-sided native valve infective endocarditis.
We sought to evaluate the impact of early surgery in the active phase on long-term outcomes in patients with left-sided native valve infective endocarditis. ⋯ Compared with conventional treatment, early surgery in the active phase was associated with better long-term outcomes in patients with left-sided native valve infective endocarditis. Further prospective randomized studies with large study populations are necessary to evaluate more precisely the optimal timing of surgery in patients with native valve infective endocarditis.
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Patients undergoing emergency coronary artery bypass grafting represent a unique and high-risk population that remains challenging for cardiac surgeons. We examined the changing trends in patients undergoing emergency bypass grafting over the past 20 years. ⋯ Despite a changing preoperative risk profile, the operative mortality of emergency coronary artery bypass grafting has remained stable over the years. However, mortality remains significantly above the observed mortality in elective bypass grafting. Continued improvements in the management of heart failure and the care of the elderly will likely result in reduced risks of emergency coronary artery bypass grafting.
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Review Meta AnalysisIntramyocardial bone marrow stem cell transplantation during coronary artery bypass surgery: a meta-analysis.
Experimental and clinical studies have suggested that intramyocardial bone marrow stem cell transplantation combined with coronary artery bypass grafting might improve left ventricular function in the setting of chronic ischemic heart disease. We therefore conducted a systematic review and meta-analysis of available publications regarding the efficacy and safety of intramyocardial bone marrow stem cell transplantation during coronary artery bypass grafting. ⋯ Clinical evidence suggests that intramyocardial bone marrow stem cell transplantation in combination with coronary artery bypass grafting is associated with improvements of functional parameters in patients with chronic ischemic heart disease. Furthermore, surgical intramyocardial bone marrow stem cell transplantation seems to be safe.
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Multicenter Study Comparative StudyClinical and hemodynamic outcomes of "all-comers" undergoing transapical aortic valve implantation: results from the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA).
The aim of this study was to assess clinical and hemodynamic outcomes of transapical aortic valve implantation (TA-TAVI) in patients enrolled in the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA). ⋯ TA-TAVI represents a safe and effective alternative treatment for patients who are inoperable or at high risk for surgery. The occurrence of an intraoperative complication significantly affects survival. Procedural volume and learning curve have no impact on patient survival.
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Aortic valve surgery: marked increases in volume and significant decreases in mechanical valve use--an analysis of 41,227 patients over 5 years from the Society for Cardiothoracic Surgery in Great Britain and Ireland National database.
Aortic valve replacement is accepted as a standard treatment for aortic stenosis and regurgitation. To help plan the national requirement for conventional and catheter-based procedures, we have analyzed the Society for Cardiothoracic Surgery in Great Britain and Ireland audit database to look at changes in practice over time. ⋯ We have seen a large increase in annual volume of aortic valve replacements, with more patients undergoing surgery for aortic stenosis and an increase in surgery in the elderly and high-risk patients.