The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2012
Randomized Controlled TrialProphylactic tricuspid annuloplasty in patients with dilated tricuspid annulus undergoing mitral valve surgery.
Progression of functional tricuspid regurgitation is not uncommon after mitral valve surgery and is associated with poor outcomes. We tested the hypothesis that concomitant tricuspid valve annuloplasty in patients with tricuspid annulus dilatation (≥40 mm) prevents tricuspid regurgitation progression after mitral valve surgery. ⋯ Prophylactic tricuspid valve annuloplasty in patients with dilated tricuspid annulus undergoing mitral valve surgery was associated with a reduced rate of tricuspid regurgitation progression, improved right ventricular remodeling, and better functional outcomes.
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J. Thorac. Cardiovasc. Surg. · Mar 2012
Active ectopic thymus predicts poor outcome after thymectomy in class III myasthenia gravis.
The presence of ectopic thymic tissue has been considered one of the most significant predictors of poor outcome after thymectomy for myasthenia gravis, but the role of active ectopic tissue is unknown. The current study analyzed the importance of this factor on post-thymectomy outcome of patients with class III myasthenia gravis. ⋯ Extended thymectomy yields good outcome in patients with nonthymomatous class III myasthenia gravis. The presence of active ectopic thymus was the most significant predictor of poor outcome. These patients should be rigorously followed and undergo early aggressive therapy.
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J. Thorac. Cardiovasc. Surg. · Mar 2012
Exercise capacity and cardiac reserve in children and adolescents with corrected pulmonary atresia with intact ventricular septum after univentricular palliation and biventricular repair.
Management of pulmonary atresia with intact ventricular septum is challenging and depends on the severity of right ventricular hypoplasia. Clinical outcomes of biventricular repair seem favorable to univentricular palliation, but data on superiority of biventricular repair regarding exercise capacity are conflicting. We investigated the response to physical and pharmacologic stress in patients with surgically corrected pulmonary atresia with intact ventricular septum. ⋯ Impaired exercise capacity in children and adolescents with pulmonary atresia with intact ventricular septum after univentricular palliation is related to decreased cardiac reserve and inadequate chronotropic response. Young patients with pulmonary atresia with intact ventricular septum after biventricular repair show normal exercise capacity and cardiac reserve.
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J. Thorac. Cardiovasc. Surg. · Mar 2012
Review Meta AnalysisBenefits and risks of using clopidogrel before coronary artery bypass surgery: systematic review and meta-analysis of randomized trials and observational studies.
The benefits and risks associated with the use of clopidogrel before coronary artery bypass grafting are controversial, and these were investigated in the present meta-analysis. ⋯ Contrary to the findings of post hoc analyses of randomized trials, observational studies showed that recent exposure to clopidogrel before coronary artery bypass grafting is associated with increased risk of postoperative death, reoperations for bleeding, blood loss, and need of blood transfusions.
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J. Thorac. Cardiovasc. Surg. · Mar 2012
Randomized Controlled Trial Multicenter Study Comparative StudyOn-pump versus off-pump coronary artery bypass surgery in high-risk patients: operative results of a prospective randomized trial (on-off study).
To analyze the risk reduction of cardiopulmonary bypass complications between on-pump and off-pump coronary artery bypass grafting in high-risk patients. ⋯ Off-pump coronary artery bypass grafting reduces early mortality and morbidity in high-risk patients.