The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Limited root repair in acute type A aortic dissection is safe but results in increased risk of reoperation.
Management of the aortic root is a challenge for surgeons treating acute type A aortic dissection. ⋯ Limited root repair was associated with increased risk of late reoperation after repair of acute type A aortic dissection. Surgeons with adequate experience may consider aortic root replacement in well-selected patients. However, given good outcomes after limited root repair, surgeons should not feel compelled to perform this more-complex operation.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Observational StudyD-dimer is associated with arterial and venous coronary artery bypass graft occlusion.
In this observational prospective study, we assessed the role of clinical variables and circulating biomarkers in graft occlusion at 18 months to identify a signature for graft occlusion. ⋯ We identified D-dimer as a biomarker associated with arterial and venous grafts occlusion. This may help stratify patients at risk of graft failure and identify new molecular targets to prevent this complication.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Minimally invasive coronary artery bypass grafting with bilateral internal thoracic arteries: Will this be the future?
The aim was to show that total arterial revascularization via a left minithoracotomy using bilateral internal thoracic arteries was not only feasible but also a safe and reproducible procedure with excellent midterm outcomes. ⋯ Multivessel total arterial revascularization was performed using the left internal thoracic artery-right internal thoracic artery Y composite conduit via a left minithoracotomy and showed that it was safe and reproducible. The midterm outcomes have been good, and coronary angiograms showed widely patent grafts. This novel technique may help optimize minimally invasive coronary surgery and the use of bilateral internal thoracic arteries. Further, this technique has the potential for decreased morbidity, shorter hospital stay, cosmesis, and earlier return to active life.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Differences and similarities in risk factors for postoperative acute kidney injury between younger and older adults undergoing cardiac surgery.
Acute kidney injury is a frequent complication after cardiac surgery. The purpose of this study was to assess the risk factors for acute kidney injury in patients ≤60 years of age undergoing cardiac surgery and to compare these risk factors with those identified in patients ≥65 years of age. ⋯ This study identified both common and distinct risk factors associated with postoperative increase in serum creatinine between patients ≤60 years and those ≥65 years undergoing cardiac surgery. Importantly, all potentially modifiable risk factors were present in both groups.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Preoperative thoracic false lumen branches are predictors of aortic enlargement after stent grafting for DeBakey IIIb aortic dissection.
The study objective was to assess the effect of preoperative thoracic false lumen branches on thoracic aortic enlargement along the stent graft after thoracic endovascular aortic repair for DeBakey IIIb aortic dissection. ⋯ Preoperative thoracic false lumen branches are a morphologic predictor of thoracic aortic enlargement along the stent graft in DeBakey IIIb aortic dissection after thoracic endovascular aortic repair.