The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Multicenter Study Clinical TrialOne-year outcomes of the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve (TRITON) trial: a prospective multicenter study of rapid-deployment aortic valve replacement with the EDWARDS INTUITY Valve System.
A new class of rapid-deployment aortic valves has emerged with the potential to simplify minimally invasive aortic surgery and reduce crossclamp and cardiopulmonary bypass times. We report the 1-year clinical outcomes of aortic valve replacement with the EDWARDS INTUITY Valve System (Edwards Lifesciences LLC, Irvine, Calif) in the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve (TRITON) trial. ⋯ Implantation of the EDWARDS INTUITY Valve System is feasible, safe, and efficacious for aortic valve replacement. Aortic crossclamp and cardiopulmonary bypass times were reduced compared with those for conventional aortic valve replacement. Early hemodynamic performance was excellent and remained so up to 1 year.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyA comparison of quality and cost indicators by surgical specialty for lobectomy of the lung.
This investigation compared patients undergoing lobectomy for non-small cell lung cancer by either a general surgeon or a cardiothoracic surgeon across a geographically diverse system of hospitals to see whether a significant difference in quality or cost was present. ⋯ This review found that currently measurable indicators for quality of care were significantly superior and overall charges were significantly reduced when a lobectomy for non-small cell lung cancer was performed by a cardiothoracic surgeon rather than by a general surgeon.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyOutcomes of interrupted aortic arch repair using the carotid artery turndown procedure.
Interrupted aortic arch is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease. Multiple surgical modalities exist to address this defect. We evaluate the long-term outcome of interrupted aortic arch with the left carotid artery turndown technique from a single institution. ⋯ Left carotid artery turndown offers a favorable surgical outcome. It compares with end-to-end repair, while providing a tension-free anastomosis and avoiding neonatal circulatory arrest and cardiopulmonary bypass. Disadvantages include a 2-stage repair and a significant reintervention rate, particularly when compared with the aortic arch advancement technique. Nevertheless, the reduced exposure to circulatory arrest and bypass and avoidance of left bronchial obstruction are important considerations that may offset these limitations.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Multicenter StudyMidterm results after endovascular treatment of acute, complicated type B aortic dissection: the Talent Thoracic Registry.
To assess the efficacy and midterm results of endovascular treatment of acute complicated type B dissection. ⋯ Endovascular stent graft placement in acute complicated type B aortic dissection proves to be a promising alternative therapeutic treatment modality in this relatively difficult patient cohort. Refinements, especially in stent design and application, could further improve the prognosis of patients in this life-threatening situation.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Randomized Controlled Trial Comparative StudyShould all moderate coronary lesions be grafted during primary coronary bypass surgery? An analysis of progression of native vessel disease during a randomized trial of conduits.
Whether to graft a moderately stenosed coronary vessel remains debatable. We investigated whether grafting such vessels is warranted based on angiographic evidence of disease progression. ⋯ The greater risk of progression of left-sided moderate lesions, and high graft patency rates when bypassed, suggests that the balance of clinical judgment lies in favor of grafting moderate left-sided lesions. In the right coronary system, however, a lesion is likely to remain moderate if left ungrafted and, with a low risk of progression, it may be reasonable to leave these vessels undisturbed.