The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Comparative StudyManagement of dilated ascending aorta during aortic valve replacement: valve replacement alone versus aorta wrapping versus aorta replacement.
The optimal management of dilated ascending aorta during aortic valve replacement (AVR) remains controversial. This study compared the outcomes among 3 different managements (AVR alone, aorta wrapping, and aorta replacement) for the dilated ascending aorta. ⋯ Compared with concomitant aortic wrapping or replacement, AVR alone achieved similar clinical outcomes, showing considerably low risks of adverse aortic events or relevant aortic expansion in dilated ascending aorta. These findings argue against routine aortic replacement at the time of AVR.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Increased plasma homocysteine predicts arrhythmia recurrence after minimally invasive epicardial ablation for nonvalvular atrial fibrillation.
Minimally invasive epicardial ablation via right minithoracotomy is an emerging option for patients with drug-refractory nonvalvular atrial fibrillation. To guide the development of rational treatment algorithms, factors predisposing to recurrence of arrhythmia need to be quantified and eventually treated. We addressed the association of the plasma levels of homocysteine and the recurrence of atrial fibrillation after minimally invasive ablation. ⋯ The homocysteine level measured during the follow-up reliably predicts the risk of recurrence after epicardial ablation of nonvalvular atrial fibrillation via minithoracotomy. Specific treatments to reduce plasma homocysteine could be considered in the future in these patients.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Isolated tricuspid valve surgery in patients with previous cardiac surgery.
Few studies have been published in literature on outcomes of isolated tricuspid valve (TV) surgery when performed as a reoperation. Hence, we analyzed our early and midterm results of TV surgery in this unique group of patients. ⋯ Postoperative results of isolated TV surgery as a reoperation are acceptable when performed electively but dismal in patients undergoing nonelective surgery. Thus, redo TV surgery, when indicated, should be performed sooner rather than later. Minimally invasive surgery through a right lateral minithoracotomy is a safe approach for patients with elective surgery.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Modified Sakakibara classification system for ruptured sinus of Valsalva aneurysm.
To introduce a modified Sakakibara classification system for a ruptured sinus of Valsalva aneurysm. ⋯ The modified classification system for ruptured sinus of Valsalva aneurysm is simple and practical for clinical use.
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J. Thorac. Cardiovasc. Surg. · Oct 2013
Edge-to-edge repair for prevention and treatment of mitral valve systolic anterior motion.
The edge-to-edge technique has been proposed to prevent systolic anterior motion (SAM) of the mitral valve. There is limited clinical data available on outcomes of this technique for this indication. We reviewed the midterm results of this technique for SAM prevention and treatment. ⋯ Initiating an expectation for prebypass SAM prediction, combined with a surgical SAM prevention strategy, resulted in a reduced prevalence of SAM compared with our model of observed to-expected-ratios and to published norms.