The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Does new-onset postoperative atrial fibrillation after coronary artery bypass grafting affect postoperative quality of life?
New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. We investigated the effect of POAF on quality of life after coronary artery bypass grafting. ⋯ New-onset POAF does affect 6-month postoperative mental and physical health, possibly warranting more aggressive POAF treatment.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Genotype-phenotype correlation in patients with bicuspid aortic valve and aneurysm.
Bicuspid aortic valve is the most common congenital cardiac abnormality, occurring in 1% to 2% of the population, and often associates with ascending aortic aneurysm. Based on familial studies, bicuspid aortic valve with aneurysm segregates in an autosomal dominant manner with incomplete penetrance. NOTCH1 mutations have been reported in 6 families with prominent valve calcification and dysfunction and low penetrance of aneurysm. We sought to determine the contribution of NOTCH1 mutations to the more common phenotype of highly penetrant aneurysms with low penetrance of bicuspid aortic valve and with rare valve calcification or dysfunction. ⋯ These data suggest that there are phenotypic differences that distinguish families with and without NOTCH1 mutations, indicating a genotype-phenotype correlation with potential implications for patient diagnosis, counseling, and management.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Noninvasive estimation of central venous pressure after Fontan procedure using biochemical markers and abdominal echography.
Patients may develop liver dysfunction, including liver fibrosis, over the long term following Fontan procedure. Therefore, early detection of liver dysfunction is essential to identify those patients who are at risk. We evaluated various laboratory parameters, including liver biochemical markers, hepatic echography findings, and cardiac catheterization outcomes, at an early stage after undergoing Fontan procedure. ⋯ Our study showed that we can predict inferior vena cava pressure using noninvasive abdominal echography and biochemical markers at an early stage after Fontan procedure.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Mild postoperative acute kidney injury and outcomes after surgery for congenital heart disease.
The effect of mild acute kidney injury (AKI) on outcomes after heart surgery in children is unclear. We sought to characterize the epidemiology of mild AKI associated with surgery for congenital heart disease (CHS-AKI) in children. ⋯ AKI occurs after surgery for congenital heart disease but may be less common than previously reported. Although moderate to severe CHS-AKI is independently associated with prolonged recovery after heart surgery, mild disease does not appear to be.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Identifying predictors of hepatic disease in patients after the Fontan operation: a postmortem analysis.
We characterized the histologic liver changes that occur after the Fontan operation and identified the factors associated with worsening hepatic disease. ⋯ The interval from the initial Fontan operation to death is associated with increased sinusoidal and portal fibrosis. In this small cohort, older age at Fontan operation was associated with sinusoidal fibrosis. Significant sinusoidal fibrosis was observed in patients who died early after the Fontan operation, with more severe disease present in patients with heterotaxy syndrome.