The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2018
Comparative StudySurvival and reoperation after valve-sparing root replacement and root repair in acute type A dissection.
Optimal treatment of the dissected root in type A dissection is still controversial. Valve-sparing techniques offer the advantage of better valve performance compared with mechanical valves or bioprostheses. The role of the different valve-preserving methods-root repair and replacement-needs further evaluation. ⋯ With the different conditions in each group in this study on patients with acute type A dissection the valve-preserving root repair technique has similar long-term rates of survival and reoperation compared with root replacement techniques, underlining its usefulness as a less complex and even faster surgical technique if individually indicated.
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J. Thorac. Cardiovasc. Surg. · Dec 2018
The impact of preoperative chronic kidney disease on outcomes after Crawford extent II thoracoabdominal aortic aneurysm repairs.
To determine whether preoperative chronic kidney disease (CKD) is predictive of poor outcomes in patients who undergo Crawford extent II thoracoabdominal aortic aneurysm (TAAA) repair. ⋯ In patients who present with CKD, extent II open TAAA repair carries considerable risks of operative death and adverse events. Further investigation is needed to improve renal protection during such repair.
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J. Thorac. Cardiovasc. Surg. · Dec 2018
Multicenter Study Comparative Study Pragmatic Clinical TrialMini-Stern Trial: A randomized trial comparing mini-sternotomy to full median sternotomy for aortic valve replacement.
Aortic valve replacement (AVR) can be performed either through full median sternotomy (FS) or upper mini-sternotomy (MS). The Mini-Stern trial aimed to establish whether MS leads to quicker postoperative recovery and shorter hospital stay after first-time isolated AVR. ⋯ Compared with FS for AVR, MS did not result in shorter hospital stay, faster recovery, or improved survival and was not cost-effective. The MS approach is not superior to FS for performing AVR.
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J. Thorac. Cardiovasc. Surg. · Dec 2018
Comparative StudyPrediction of postoperative lung function after major lung resection for lung cancer using volumetric computed tomography.
The study objectives were to assess the accuracy of volumetric computed tomography to predict postoperative lung function in patients with lung cancer in relation to anatomic segments counting and perfusion scintigraphy, to generate specific predictive equations for each functional parameter, and to evaluate accuracy and precision of these in a validation cohort. ⋯ Volumetric computed tomography is a reliable and accurate method to predict postoperative lung function in patients undergoing lung resection that provides better accuracy than conventional procedures. Because lung computed tomography is systematically performed in the staging of patients with suspected lung cancer, this volumetric analysis might simultaneously provide the information necessary to evaluate operability.
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J. Thorac. Cardiovasc. Surg. · Dec 2018
Open surgical thoracoabdominal aortic aneurysm repair: The Heidelberg experience.
Open surgical repair of thoracoabdominal aortic aneurysm remains an important treatment option and continues to be challenging. The objective of this study was to investigate the results after open repair of thoracoabdominal aortic aneurysms in a contemporary non-high-volume center collective. ⋯ Despite the invasiveness of open thoracoabdominal aortic repair and significant risk of major complications, surgical repair can be accomplished in a non-high-volume center with acceptable results.