The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Outcomes of cardiac surgery in patients weighing <2.5 kg: affect of patient-dependent and -independent variables.
A recent Society of Thoracic Surgeons database study showed that low weight (<2.5 kg) at surgery was associated with high operative mortality (16%). We sought to assess the outcomes after cardiac repair in patients weighing <2.5 kg versus 2.5 to 4.5 kg in an institution with a dedicated neonatal cardiac program and to determine the potential role played by prematurity, the Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) risk categories, uni/biventricular pathway, and surgical timing. ⋯ A dedicated multidisciplinary neonatal cardiac program can yield good outcomes for neonates and infants weighing <2.5 kg independently of the STAT risk category and uni/biventricular pathway. A lower gestational age at birth was an independent risk factor for hospital mortality.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Clostridium difficile infection after cardiac surgery: prevalence, morbidity, mortality, and resource utilization.
Despite increasing efforts to prevent infection, the prevalence of hospital-associated Clostridium difficile infections (CDI) is increasing. Heightened awareness prompted this study of the prevalence and morbidity associated with CDI after cardiac surgery. ⋯ Although rare, the prevalence of CDI is increasing, contributing importantly to morbidity and mortality after cardiac surgery. If toxic colitis develops, mortality is high, but colectomy may be lifesaving.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Survival after intervention in patients with low gradient severe aortic stenosis and preserved left ventricular function.
The outcome of aortic valve replacement for patients with low gradient severe aortic stenosis and preserved ejection fraction has been debated. The aim of the present study was to evaluate the effect of aortic valve intervention on survival in that group. ⋯ Our findings suggest that aortic valve intervention is associated with improved survival among patients with low gradient severe aortic stenosis and preserved left ventricular function. The presence of either a low or normal stroke volume index did not affect the mortality benefit.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Long-term results of aggressive hemiarch replacement in 534 patients with type A aortic dissection.
To present the outcomes of routinely performed hemiarch replacement in patients with acute type A aortic dissection. ⋯ Aggressive hemiarch replacement in acute type A dissection can be performed with low mortality and low aortic arch reoperation rate. Resection of all dissected aortic wall tissue decreases, but does not eliminate, the risk of later adverse aortic events.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Systolic anterior motion of the mitral valve: a 30-year perspective.
Systolic anterior motion (SAM) can occur after mitral valve repair (MVr), most frequently in patients with degenerative valve disease. Our initial observations (1981-1990) revealed that most patients with SAM can be successfully treated medically. Here the authors review the last 16 years of their experience with SAM after MVr. ⋯ In the more recent era, SAM occurs one-third less frequently after repair of degenerative mitral valve disease. Use of an incomplete annuloplasty band rather than a complete ring is associated with a lower incidence of SAM. The mainstay treatment of SAM continues to be medical management.