The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Observational StudyReoperative aortic valve replacement in the octogenarians-minimally invasive technique in the era of transcatheter valve replacement.
Reoperative aortic valve replacement (re-AVR) in octogenarians is considered high risk and therefore might be indicated for transcatheter AVR. The minimally invasive technique for re-AVR limits dissection and might benefit this patient population. We report the outcomes of re-AVR in high-risk octogenarians who might be considered candidates for transcatheter AVR to assess the safety of re-AVR and minimally invasive operative techniques. ⋯ Octogenarians who undergo re-AVR are thought to be high-risk surgical candidates. The present single-center series revealed acceptable in-hospital outcomes and operative mortality. Mre-AVR was associated with better survival compared with Fre-AVR and might benefit this population.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
The influence of preoperative weight loss on the postoperative course after esophageal cancer resection.
Preoperative weight loss might increase the risk of postoperative morbidity and mortality after esophagectomy for cancer. We hypothesized that patients with esophageal cancer with >10% weight loss during the 3 months before their diagnosis would be at an increased risk of postoperative complications, have a longer length of stay, and have worse overall survival. ⋯ A >10% preoperative weight loss was followed by decreased 5-year survival after esophageal cancer surgery but no increased risk of postoperative complications.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Understanding variability in hospital-specific costs of coronary artery bypass grafting represents an opportunity for standardizing care and improving resource use.
This study was undertaken to examine interhospital variability in inpatient costs of coronary artery bypass grafting (CABG). ⋯ There is a wide variation in the cost of performing CABG in the United States. We determined that individual hospital centers, independent of multiple patient- and outcome-specific factors, are drivers of these differences. Comparison of hospital-specific behavior with identification of the causes of cost discrepancies represents an opportunity for standardization of care and improvement in resource use.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Outcomes of surgery in the treatment of isolated nonnative mitral valve infective endocarditis.
We reviewed our experience with the operative management of patients with isolated nonnative mitral valve infective endocarditis to better understand the outcome. ⋯ Surgery for isolated nonnative mitral valve infective endocarditis carries increased operative risk. Aggressive debridement and reconstruction of the annulus are paramount to achieving a good outcome. Surviving patients obtain high rates of cure and freedom from recurrent infective endocarditis.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Off-pump transapical implantation of artificial chordae to correct mitral regurgitation: early results of a single-center experience.
This study evaluated the safety and efficiency of the NeoChord DS1000 system (NeoChord, Inc, Minneapolis, Minn), a device designed to deliver artificial chordae tendineae (neochords) in a beating heart with minimally invasive techniques through left anterolateral minithoracotomy. ⋯ Beating-heart transapical neochord implantation was feasible, could be performed safely, and resulted in a relatively short procedure time. Larger studies and longer follow-up are needed to validate these promising results.