The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Multicenter Study Clinical TrialDynamic annuloplasty for mitral regurgitation.
The MiCardia DYANA annuloplasty system (MiCardia Corp, Irvine, Calif) is a nitinol-based dynamic complete ring that allows modification of the septal-lateral diameter under transesophageal echocardiography guidance in the loaded beating heart after mitral valve repair. Shape alteration is induced by radiofrequency via detachable activation wires. This multicenter study reports the first human experience with this device. ⋯ The implantation of the new dynamic annuloplasty ring allows for safe mitral valve repair. The option of postrepair modification of the septal-lateral diameter by radiofrequency may further optimize repair results.
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Routine left atrial appendage ligation during cardiac surgery may prevent postoperative atrial fibrillation-related cerebrovascular accident.
The aim of the study was to determine whether routine left atrial appendage ligation in cardiac surgery would reduce the risk of postoperative atrial fibrillation-related cerebrovascular accident. ⋯ Although postoperative atrial fibrillation remains a common complication of cardiac surgery, there was a significant decrease in the incidence of postoperative cerebrovascular accidents since routine ligation of the left atrial appendage was undertaken. This has been found to be a safe adjunct to a wide variety of cardiac procedures and therefore deserves further study by a larger randomized controlled trial.
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Comparative StudyImpact of T status and N status on perioperative outcomes after thoracoscopic lobectomy for lung cancer.
We sought to evaluate the effect of tumor size, location, and clinical nodal status on outcomes after thoracoscopic lobectomy for lung cancer. ⋯ Thoracoscopic lobectomy for lung cancers that are central, clinically node positive, or >3 cm does not confer increased morbidity compared with peripheral, clinical N0 cancers that are <3 cm.
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Multicenter StudyClinical event rates with the On-X bileaflet mechanical heart valve: a multicenter experience with follow-up to 12 years.
The aim of the study was to establish clinical event rates for the On-X bileaflet mechanical heart valve (On-X Life Technologies Inc, Austin, Tex) using an audit of data from the 3 centers within Europe with the longest history of implanting. ⋯ The On-X valve has low adverse clinical event rates in longer-term follow-up (mean 5.2 years and maximum 12.6 years).
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Multicenter StudyThe RECOVER I: a multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support.
Cardiogenic shock after cardiac surgery is accompanied by a high mortality rate. Early institution of hemodynamic support with a versatile, easy to insert left ventricular assist device might help bridge patients to recovery or to the next therapy, and improve the outcomes. ⋯ The use of the Impella 5.0/left direct device is safe and feasible in patients presenting with postcardiotomy cardiogenic shock. The device was rapidly inserted, enabled early support, and yielded favorable outcomes.