The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Second crossclamp to perfect degenerative mitral valve repair: Decision-making algorithm, safety, and outcomes.
Residual mitral regurgitation reduces the efficacy of mitral repair and is associated with worse outcomes. We adopted a policy using a second bypass run for patients with residual mitral regurgitation (>+1) and described our decision-making algorithm and outcomes. ⋯ Residual mitral regurgitation can be effectively treated using a second bypass run with good long-term outcome and minimal incremental risk.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Management of acute type B aortic dissection with malperfusion via endovascular fenestration/stenting.
The study objective was to evaluate the management of malperfusion in acute type B aortic dissection with endovascular fenestration/stenting. ⋯ Patients with acute type B aortic dissection with malperfusion can be managed with endovascular fenestration/stenting with excellent short- and long-term outcomes. This approach is particularly helpful to patients with static malperfusion of aortic branch vessels.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Management of the aortic arch in patients with Loeys-Dietz syndrome.
We sought to develop strategies for management of the aortic arch in patients with Loeys-Dietz syndrome (LDS) through a review of our clinical experience with these patients and a comparison with our experience in patients with Marfan syndrome (MFS). ⋯ In the absence of dissection, patients with LDS have a greater rate of arch intervention after root surgery than patients with MFS. After a dissection, arch reintervention rates are similar in the 2 groups. Arch intervention portends greater late mortality in LDS.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Impact of prior diaphragm plication on subsequent stages of single ventricle palliation.
Phrenic nerve injury is a known cause of morbidity after single ventricle palliation. Previous studies have shown that hemidiaphragm plication improves short-term outcomes. The effect of plication on the outcomes of subsequent stages of single ventricle palliation is unknown. ⋯ Prior diaphragm plication does not adversely affect Fontan completion in children with single ventricle physiology. The hospital course during subsequent stages of palliation for plicated patients was no different than that of matched controls.