The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Jul 2014
Multicenter Study Clinical TrialHemodynamic outcomes of geometric ring annuloplasty for aortic valve repair: a 4-center pilot trial.
A geometric annuloplasty ring could improve efficacy and stability of aortic valve repair. Toward this goal, a 1-piece 3-dimensional titanium annuloplasty ring with Dacron covering was developed and tested successfully in animals. The purpose of this study was to define hemodynamic outcomes with this device used as the annuloplasty component of human aortic valve repair. ⋯ Geometric ring annuloplasty facilitated aortic valve repair, allowing more precise reconstruction of leaflet defects. Aortic insufficiency reduction and systolic gradients were excellent, and expansion of valve reconstruction into broader categories of aortic valve disease seems indicated.
-
J. Thorac. Cardiovasc. Surg. · Jul 2014
Comparative Study Observational StudyAortic valve replacement after previous heart surgery in high-risk patients: transapical aortic valve implantation versus conventional aortic valve replacement-a risk-adjusted and propensity score-based analysis.
Cardiac reoperations have been associated with increased morbidity and mortality compared with first-time surgery. We analyzed our experience with reoperative aortic valve replacement (redo-AVR) and compared these results with those from patients who had undergone transapical aortic valve implantation (TA-AVI) as a second heart operation. ⋯ Redo-AVR can be performed with acceptable results in high-risk patients and still serves as the reference standard. Reoperative valve surgery by TA-AVI is feasible and results in comparable short- and mid-term survival.
-
J. Thorac. Cardiovasc. Surg. · Jul 2014
Pretransplant serum human chitinase-like glycoprotein YKL-40 concentrations independently predict bronchiolitis obliterans development in lung transplant recipients.
Bronchiolitis obliterans syndrome (BOS) is the main long-term complication limiting survival after lung transplantation. There exists no cure for BOS and its mechanisms are not well understood. Early identification of BOS could therefore contribute to improvement of therapeutic and preventive measures. The human chitinase-like glycoprotein YKL-40 is involved in regulation of inflammatory tissue response and remodeling and is associated with pulmonary fibrosis. However, its role in BOS is unknown. ⋯ Elevated pretransplant serum YKL-40 concentration is associated with BOS development and could be an independent biomarker in early prediction and monitoring of BOS.