The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative StudyNew engineering treatment of bovine pericardium confers outstanding resistance to calcification in mitral and pulmonary implantations in a juvenile sheep model.
To conduct a test of noninferiority for CardioCel (Admedus, Brisbane, Australia), a chemically engineered bovine pericardium over autologous pericardium treated intraoperatively with glutaraldehyde in a chronic juvenile sheep model of pulmonary valve (PV) and mitral valve (MV) reconstruction. ⋯ In this growing lamb model the CardioCel patch allowed accurate valve repair at both systemic and pulmonary pressure. The mechanical properties of CardioCel after 7 months were preserved with a more controlled healing than the treated autologous pericardium and without calcification.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Successful surgical management of ventricular fibromas in children.
A uniform management strategy has not been established for the treatment of large ventricular fibromas identified in children. The goal of the present study was to review our experience with surgical resection of this uncommon tumor. ⋯ Primary ventricular fibromas, even when very large, can be managed by surgical resection, with excellent short- and intermediate-term ventricular function and relief of arrhythmic events.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Long-term follow-up of asymptomatic or mildly symptomatic patients with severe degenerative mitral regurgitation and preserved left ventricular function.
The timing for mitral valve surgery in asymptomatic patients with severe mitral regurgitation and preserved left ventricular function remains controversial. We analyzed the immediate and long-term outcomes of these patients after surgery. ⋯ Mitral valve repair can be achieved in the majority of patients with low mortality (<1%) and excellent long-term survival. Patients with atrial fibrillation/pulmonary hypertension had compromised long-term survival, particularly younger patients (aged <65 years), and are at increased risk of mitral reoperation.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Observational StudyTransapical aortic valve implantation in patients with poor left ventricular function and cardiogenic shock.
In line with our institutional no exclusion policy we accept patients with very poor left ventricular performance and cardiogenic shock for transcatheter aortic valve implantation (TAVI). The purpose of our study was to analyze outcome in these patients and to identify what happens to the left ventricular function after TAVI in patients with failing ventricles. ⋯ In the majority of patients with failing ventricles, left ventricular function is quickly restored after TAVI and elimination of aortic stenosis. Without the additional trauma of cardioplegic arrest, TAVI is the potentially superior treatment option in patients with poor and very poor left ventricular performance.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Outcomes of peripheral perfusion with balloon aortic clamping for totally endoscopic robotic mitral valve repair.
Although the technique of totally endoscopic robotic mitral valve repair (TERMR) has been well described, few reports have examined the results of peripheral perfusion with balloon clamping. We analyzed the outcomes of TERMR performed using this strategy. ⋯ A preoperative image-guided perfusion strategy and aortic balloon clamping permit routine TERMR with excellent myocardial preservation and minimal complications.