The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2015
Comparative StudyOn-pump coronary artery bypass graft operation: Is one crossclamp application better than two?
Several factors may increase the risk of stroke during coronary artery bypass grafting. These include age and atherosclerosis, which are not modifiable, and aortic manipulation, which may be modifiable. This study reports our experience with variable degrees of aortic manipulation (ie, single vs double [partial occlusion] aortic crossclamp techniques) and its influence on rate of operative stroke. ⋯ Given the methods and limitations of the data analysis, the single and partial aortic crossclamp techniques result in similar rates of stroke during on-pump coronary artery bypass grafting.
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J. Thorac. Cardiovasc. Surg. · Jul 2015
Comparative StudyGreater asymmetric wall shear stress in Sievers' type 1/LR compared with 0/LAT bicuspid aortic valves after valve-sparing aortic root replacement.
To evaluate the role of commissure orientation on downstream blood flow patterns and ascending aortic wall shear stress (WSS) in patients with bicuspid aortic valves (BAV) after valve-sparing aortic root replacement (V-SARR). ⋯ After V-SARR, BAV cusp morphology has a major impact on the pattern of blood flow and WSS in the ascending aorta.
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J. Thorac. Cardiovasc. Surg. · Jul 2015
Is there an outcome penalty linked to guideline-based indications for valvular surgery? Early and long-term analysis of patients with organic mitral regurgitation.
The timing of surgical correction of mitral regurgitation remains controversial. A major source of dispute regards the potential short- and long-term postoperative outcome penalty associated with the type of guideline-based indication for surgery. ⋯ The type of guideline-based indication for surgical correction of organic mitral regurgitation is associated with profound outcome consequences on long-term postoperative mortality and heart failure, despite low operative risk and high repair rates. Conversely, surgical correction of severe mitral regurgitation based on high probability of repair (ClassII-EarlyT) is associated with improved survival and low heart failure risk and should be the preferred strategy in valve centers offering low operative risk and high repair rates.
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J. Thorac. Cardiovasc. Surg. · Jul 2015
Surgical repair for primary pulmonary vein stenosis: Single-institution, midterm follow-up.
Primary pulmonary vein stenosis (PVS) is a rare congenital heart condition and carries a poor prognosis. ⋯ Detailed morphologic evaluation of each PV involved is a consideration for surgery, and is closely related to the prognosis. Moderate or severe primary PVS is worse than mild PVS, and no differences were found in effectiveness among endarterectomy, pericardial patch venoplasty, and sutureless pericardial marsupialization in treating primary PVS.
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J. Thorac. Cardiovasc. Surg. · Jul 2015
The Freedom Solo pericardial stentless valve: Single-center experience, outcomes, and long-term durability.
To report our institutional experience and long-term results with the Freedom Solo bovine pericardial stentless bioprosthesis (Sorin Group, Saluggia, Italy). ⋯ The Freedom Solo stentless aortic valve is safe to implant and shows excellent early and midterm hemodynamic performance. However, SVD was observed in a substantial number of patients after only 5-6 years and the need for explantation increased markedly, suggesting low durability.