The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2016
Human leukocyte antigen mismatching and survival after lung transplantation in adult and pediatric patients with cystic fibrosis.
The influence of human leukocyte antigen (HLA) mismatching on survival in adult and pediatric patients with cystic fibrosis (CF) after lung transplantation (LTx) is unknown. ⋯ HLA mismatching has significantly different implications for survival after LTx in adult compared with pediatric patients with CF.
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J. Thorac. Cardiovasc. Surg. · Feb 2016
Comparative StudyChallenges with heparin-based anticoagulation during cardiopulmonary bypass in children: Impact of low antithrombin activity.
Antithrombin is one of the main natural coagulation system inhibitors. It is potentiated by heparin, and may be a key component of heparin response, particularly in infants aged <1 year. We sought to determine the impact of baseline antithrombin activity on response to heparin and thrombin generation during cardiopulmonary bypass (CPB). ⋯ Low circulating antithrombin activity is associated with lower heparin efficacy, which ultimately leads to a lower ability to suppress thrombin generation during CPB. Determination of risk factors for heparin resistance, and potentially, antithrombin replacement therapy, may individualize and improve anticoagulation treatment.
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J. Thorac. Cardiovasc. Surg. · Feb 2016
Comparative Study Observational StudyPreoperative characteristics and surgical outcomes of acute intramural hematoma involving the ascending aorta: A propensity score-matched analysis.
We aimed to evaluate the preoperative characteristics and surgical outcomes of acute type A intramural hematoma. ⋯ Patients with intramural hematoma have different preoperative clinical characteristics compared with patients with aortic dissection. Emergency open surgery for type A intramural hematoma demonstrated low operative mortality and excellent 5-year survival.
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J. Thorac. Cardiovasc. Surg. · Feb 2016
Comparative StudyLong-term outcomes of aortic root operations for Marfan syndrome: A comparison of Bentall versus aortic valve-sparing procedures.
Prophylactic aortic root replacement improves survival in patients with Marfan syndrome with aortic root aneurysms, but the optimal procedure remains undefined. ⋯ After prophylactic root replacement in patients with Marfan syndrome, patients undergoing Bentall and valve-sparing procedures have similar late survival, freedom from root reoperation, and freedom from endocarditis. However, valve-sparing procedures result in significantly fewer thromboembolic and hemorrhagic events.
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J. Thorac. Cardiovasc. Surg. · Feb 2016
Early and late outcomes of repaired acute DeBakey type I aortic dissection after graft replacement.
The present study aimed to determine the impact of the extent of graft replacement on early and late outcomes in acute DeBakey type I aortic dissection. ⋯ The operative mortality of patients with acute DeBakey type I aortic dissection treated by total arch replacement was acceptable with good long-term survival after both total arch replacement and non-total arch replacement. The frequency of distal aortic events might be reduced in patients after total arch replacement compared with non-total arch replacement.