The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2018
Aortic annulus does not dilate over time after aortic root remodeling with or without annuloplasty.
The lack of annular stabilization is the drawback of aortic root remodeling, and recently the addition of annuloplasty has been proposed. Limited data, however, exist on late annular size after remodeling. We studied annular size over time. ⋯ Aortic annulus rarely dilates over time after remodeling. In the case of annular dilatation, annuloplasty normalizes annular size and may prevent further dilatation by enhancing cusp coaptation. Even without annuloplasty, the aortic annulus becomes smaller compared with preoperative dimensions when aortic valve remains competent.
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J. Thorac. Cardiovasc. Surg. · Mar 2018
Extracorporeal life support as a bridge to lung transplantation-experience of a high-volume transplant center.
Extracorporeal life support (ECLS) is increasingly used to bridge deteriorating patients awaiting lung transplantation (LTx), however, few systematic descriptions of this practice exist. We therefore aimed to review our institutional experience over the past 10 years. ⋯ In our center experience, ECLS bridge to first lung transplant leads to good short-term and long-term outcomes in carefully selected patients. In contrast, our data suggest that ECLS as a bridge to retransplantation should be used with caution.
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J. Thorac. Cardiovasc. Surg. · Mar 2018
Laparoscopic transdiaphragmatic chest surgery: Early experience.
We describe laparoscopic transdiaphragmatic (LTD) chest surgery without intercostal incisions and focus on technique and safety. The goal of LTD is to minimize postoperative pain. ⋯ Early experience suggests that LTD chest surgery is feasible and safe on short- to midterm follow-up. The specific role of LTD chest surgery will require definition of patient selection criteria, further experience to reduce operative time, long-term follow-up, and prospective comparison with conventional VATS.