The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Observational StudyOutcomes of contemporary emergency open surgery for type A acute aortic dissection in elderly patients.
We sought to evaluate surgical outcomes of type A acute aortic dissection in elderly patients. ⋯ Emergency open surgery for type A acute aortic dissection in elderly patients resulted in a low mortality but high incidences of stroke and prolonged hospital stay. Preoperative cardiopulmonary resuscitation and previous cardiac surgery were significant predictors of stroke. Emergency surgery is still the primary option for most elderly patients with acute aortic dissection.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Long-term follow-up after aortic valve replacement with Edwards Prima Plus stentless bioprostheses in patients younger than 60 years of age.
The Edwards Prima Plus was one of the first stentless aortic valve bioprostheses, with larger orifice areas and improved hemodynamics compared to stented bioprostheses. The aim of the present single-center retrospective study was to assess the long-term results of the Edwards Prima Plus in patients 60 years old or younger. ⋯ In patients aged 60 years or younger, an Edwards Prima Plus can provide reliable long-term results with acceptable freedom-from-reoperation rates.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Observational StudyResidual lesions in postoperative pediatric cardiac surgery patients receiving extracorporeal membrane oxygenation support.
The objective of this study was to examine the incidence and clinical outcomes of residual lesions in postoperative pediatric cardiac surgery patients receiving extracorporeal membrane oxygenation (ECMO) support. ⋯ Residual lesions are present in approximately one-quarter of postoperative cardiac surgery patients requiring ECMO support. All postoperative pediatric cardiac surgery patients unable to be weaned off ECMO successfully should be evaluated actively for residual lesions, preferably by cardiac catheterization imaging. Earlier detection of residual lesions and reintervention are associated with improved clinical outcome.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Endovascular coil embolization of segmental arteries prevents paraplegia after subsequent thoracoabdominal aneurysm repair: an experimental model.
To test a strategy for minimizing ischemic spinal cord injury after extensive thoracoabdominal aneurysm (TAAA) repair, we occluded a small number of segmental arteries (SAs) endovascularly 1 week before simulated aneurysm repair in an experimental model. ⋯ Endovascular coiling of 2 to 4 SAs prevented paraplegia in an experimental model of extensive hybrid TAAA repair, and helped protect the spinal cord from ischemic histopathologic injury. A clinical trial in a selected patient population at high risk for postoperative spinal cord injury may be appropriate.