The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Should less-invasive aortic valve replacement be avoided in patients with pulmonary dysfunction?
In patients with pulmonary dysfunction, it is unclear whether a less-invasive approach for aortic valve replacement is well tolerated or even beneficial. We investigated whether a partial upper J-incision for aortic valve replacement leads to more favorable outcomes than a full sternotomy in patients with chronic lung disease by using forced expiratory volume in 1 second as a surrogate. ⋯ In patients with preoperative respiratory dysfunction, a less-invasive partial upper J-incision for aortic valve replacement can lead to more favorable outcomes than a full sternotomy, including shorter intensive care unit and postoperative lengths of stay and better early survival, which are amplified with decreasing pulmonary function.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Minimally invasive papillary muscle sling placement during mitral valve repair in patients with functional mitral regurgitation.
We evaluated the safety and feasibility of minimally invasive mitral valve repair with papillary muscle sling placement via a right anterior thoracotomy approach in patients with severe functional mitral regurgitation (MR). ⋯ Minimally invasive mitral repair with papillary muscle sling placement for severe functional MR is safe and effective in the short-term. Long-term data are needed to evaluate the effects on left ventricular remodeling and to assess the durability of the repair.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Repair of retrograde ascending dissection after descending stent grafting.
Retrograde dissection is now recognized as an important complication after thoracic endovascular aortic repair (TEVAR), but its treatment is poorly understood. Our objectives were to investigate the risks, describe the repair methods, and assess the outcomes of this complication. ⋯ Retrograde ascending dissection can present as an early or a late complication after descending stent grafting because of aortic instability or disease progression and has usually been associated with descending dissection or intramural hematoma. It is a life-threatening complication that can be managed safely with early recognition and rapid delivery of open or hybrid repair.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Long-term follow-up evaluation of renal function in patients treated with peritoneal dialysis after cardiac surgery for correction of congenital anomalies.
Available data on the long-term renal outcome of patients who required renal replacement therapy after cardiac surgery for correction of congenital cardiac anomalies are scarce. The aim of the present study was to investigate the long-term renal prognosis of children treated with peritoneal dialysis after surgical correction of congenital heart anomalies. ⋯ Despite the development of AKI requiring dialysis after surgical correction of congenital cardiac anomalies, the long-term renal prognosis in survivors is good.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Paracorporeal lung assist devices as a bridge to recovery or lung transplantation in neonates and young children.
To evaluate paracorporeal lung assist devices to treat neonates and children with decompensated respiratory failure as a bridge to recovery or lung transplantation. ⋯ Pediatric patients bridged from ECMO to lung transplantation have poor results. An alternative method for longer term respiratory support was necessary as a bridge for these patients. The use of a paracorporeal lung assist device successfully supported 4 patients to recovery, lung transplantation, or past the average wait time for pediatric donor lungs (27 days). This therapy has the potential to bridge children with decompensated respiratory failure to lung transplantation.