The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2017
Comparative StudyClinical implications of donor age: A single-institution analysis spanning 3 decades.
We sought to clarify the effect of donor age as a continuous variable on morbidity and mortality in a single-institution experience. ⋯ Long-term survival of lung transplant recipients was not affected by the age of the donor. These findings support the notion that donor age could be relaxed.
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J. Thorac. Cardiovasc. Surg. · Dec 2017
Comparative StudyShould annuloplasty prosthesis be selected dependent on the location of prolapse in mitral valve repair for type II dysfunction?
This study explored the influence of prosthesis selection on long-term outcomes in patients who underwent mitral valve repair for mitral insufficiency (MI) due to type II dysfunction. ⋯ Full-ring annuloplasty is indicated in the setting of anterior prolapse to prevent recurrent MI, whereas prosthesis type is not a determinant of recurrent MI in the setting of posterior prolapse.
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J. Thorac. Cardiovasc. Surg. · Dec 2017
Successful atrioventricular valve repair improves long-term outcomes in children with unbalanced atrioventricular septal defect.
Atrioventricular valve regurgitation is a significant cause of morbidity and mortality in patients with unbalanced atrioventricular septal defect. However, knowledge of the outcomes of atrioventricular valve repair in children with unbalanced atrioventricular septal defect and univentricular physiology is limited. ⋯ Atrioventricular valve surgery in patients with unbalanced atrioventricular septal defect is associated with substantial mortality and a high rate of reoperation. Successful atrioventricular valve repair is associated with better survival and freedom from reoperation.
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J. Thorac. Cardiovasc. Surg. · Dec 2017
Lung transplantation in the elderly: Influence of age, comorbidities, underlying disease, and extended criteria donor lungs.
As large registries show an increased risk for lung transplant recipients aged 60 years or more, few single centers report favorable outcomes for carefully selected older recipients without providing essential details. The purpose of our study was to determine variables that influence survival in the elderly. ⋯ The comorbidity profile, underlying disease, and donor lung quality appear to be more important than age in reducing long-term survival. Older age serves as a marker for a complex constellation of factors that might be considered the relative or absolute contraindication to lung transplantation rather than age, per se.
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J. Thorac. Cardiovasc. Surg. · Dec 2017
Favorable late survival after aortic surgery under straight deep hypothermic circulatory arrest.
Surgical and cerebral protection strategies in aortic arch surgery remain under debate. Perioperative results using deep hypothermic circulatory arrest (DHCA) have been associated with favorable short-term mortality and stroke rates. The present study focuses on late survival in patients undergoing aortic surgery using DHCA. ⋯ Aortic surgery with DHCA can be performed with favorable late survival, with the duration of DHCA period having only a limited impact. However, these results cannot be generalized for very long durations of DHCA (>50 minutes), when perfusion methods may be preferable. In elective, nondissection first-time surgeries, a late survival comparable to that in a reference population can be achieved. Early survival is adversely affected by aortic dissection, redo status, and disease extent.