The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative Study Observational StudyProfound hypothermia compared with moderate hypothermia in repair of acute type A aortic dissection.
To determine the impact of the degree of hypothermia on surgical outcomes in patients undergoing repair of acute type A aortic dissection. ⋯ MH was independently associated with a lower risk of a composite outcome of mortality and major adverse cardiac and cerebrovascular events during repair of acute type A dissection. Use of moderate hypothermic circulatory arrest avoids the detrimental effects of PH without an increase in the risk of neurologic injury in this study.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Reoperations on the total aortic arch in 119 patients: short- and mid-term outcomes, focusing on composite adverse outcomes and survival analysis.
To determine the preoperative and perioperative risk factors that significantly predict adverse outcomes after total arch replacement in patients with previous proximal aortic surgery and to analyze patient survival. ⋯ Aortic arch reoperations, although technically demanding, can produce acceptable results. Preoperative pulmonary disease, CPB time, and concomitant coronary artery bypass predicted an adverse outcome. The CPB time predicted mortality, and previous thoracoabdominal aortic surgery predicted stroke.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Observational StudyAssessment of platelet function with light transmission aggregometry in 24 patients supported with a continuous-flow left ventricular assist device: a single-center experience.
This study evaluated platelet function for an extended period of time in patients with a HeartMate II continuous-flow left ventricular assist device (Thoratec Corporation, Pleasanton, Calif) with light transmission aggregometry and investigated the potential role of this test in clinical management. ⋯ High platelet reactivity during treatment with aspirin is common in patients with a HeartMate II. Moreover, light transmission aggregometry may detect impaired ristocetin-induced platelet agglutination, enabling dosage of aspirin to be adjusted. Our strategy showed no major improvements in terms of thrombosis rate when compared with published data, although bleeding frequency was somewhat reduced. Benefits of light transmission aggregometry testing need to be assessed in a larger randomized study with a longer follow-up.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Surgery for simple and complex subaortic stenosis in children and young adults: results from a prospective, procedure-based national database.
To identify the outcomes of surgically treated subaortic stenosis in a national population. ⋯ Patients with SS had excellent outcomes. However, those with CS had worse long-term survival and freedom from reintervention, with morbidity and mortality greatest in young patients with multiple lesions. Additional evaluation in large-scale prospective studies is warranted.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction.
The short-term outcomes were evaluated in patients treated for tricuspid valve endocarditis using a novel extracellular matrix (ECM) cylinder reconstruction technique. ⋯ Cylinder reconstruction with ECM could be a suitable technique for replacing the tricuspid valve while preserving annuloventricular continuity in patients with infective endocarditis not repairable by conventional techniques.