The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2020
Anastomotic complications after esophagectomy: Influence of omentoplasty in propensity-weighted cohorts.
A recent meta-analysis of 3 randomized controlled trials reported reduced incidence and severity of postesophagectomy anastomotic dehiscence with anastomotic omentoplasty. Unfortunately, these trials excluded neoadjuvant patients who received chemoradiation. We aimed to determine whether anastomotic omentoplasty was associated with differential postesophagectomy anastomotic complications after neoadjuvant chemoradiotherapy. ⋯ Within the limits of our sample size and statistical approach, our study failed to find evidence that anastomotic omentoplasty during esophagectomy after neoadjuvant chemoradiation reduced anastomotic leak rate or need for leak-related reoperation.
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J. Thorac. Cardiovasc. Surg. · May 2020
Comparative StudyInfluence of warfarin on cardiac and cerebrovascular events following bioprosthetic aortic valve replacement: A nationwide cohort study.
The need for anticoagulation treatment following bioprosthetic aortic valve replacement remains controversial. We investigated the associations of warfarin treatment with the risks of major adverse cardiac and cerebrovascular events, including mortality, bleeding incidents, and reoperation requirement after bioprosthetic aortic valve replacement surgery. ⋯ Short-term use of postoperative warfarin (especially <30 days) following bioprosthetic aortic valve replacement may be associated with a reduction in MACCE compared with nonuse.
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J. Thorac. Cardiovasc. Surg. · May 2020
Effects of genetic transfection on calcium cycling pathways mediated by double-stranded adeno-associated virus in postinfarction remodeling.
Restoring calcium sensor protein (S100A1) activity in failing hearts poses a promising therapeutic strategy. We hypothesize that cardiac overexpression of the S100A1 gene mediated by a double-stranded adeno-associated virus (scAAV) results in better functional and molecular improvements compared with the single-stranded virus (ssAAV). ⋯ Gene therapy of S100A1 can prevent pathologic postmyocardial infarction remodeling and decrease inflammatory response in ischemic heart failure.
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J. Thorac. Cardiovasc. Surg. · May 2020
Serial cardiac magnetic resonance imaging after surgical coronary revascularization for left ventricular dysfunction.
Serial changes in segmental myocardial function after surgical myocardial revascularization have not been well demonstrated. This study was conducted to evaluate improvements in segmental myocardial function after coronary artery bypass grafting in patients with left ventricular dysfunction. ⋯ One third of segments with a transmural extent of LGE >50% still had a chance for improvement after revascularization, although an inverse correlation was seen between the LGE grade and improvement of segmental myocardial function.
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J. Thorac. Cardiovasc. Surg. · May 2020
Optimized mitral annuloplasty ring design reduces loading in the posterior annulus.
The study objective was to develop a novel annuloplasty ring with regional flexibility and assess its suture force dynamics in healthy ovine subjects compared with fully rigid or fully flexible rings. ⋯ The reduced FC of the heterogeneous ring relative to the fully rigid ring suggests a promising approach to reduce suture loading while preserving the annular remodeling capability of fully rigid rings. Future studies in diseased subjects are necessary to explore repair effectiveness of this ring.