The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2021
Comparative Study Observational StudyEquivalent 10-year angiographic and long-term clinical outcomes with saphenous vein composite grafts and arterial composite grafts.
We compared 10-year graft patency rates and long-term clinical outcomes after off-pump coronary artery bypass grafting using the saphenous vein composite grafts based on the left internal thoracic artery with those using total arterial composite grafts. ⋯ The saphenous vein composite grafts were equivalent to arterial composite grafts in terms of 10-year graft patency and long-term clinical outcomes.
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J. Thorac. Cardiovasc. Surg. · Nov 2021
Neonatal heart transplant outcomes: A single institutional experience.
Neonatal orthotopic heart transplantation was introduced in the 1980s as a treatment for complex congenital heart disease. Progress in single-ventricle palliation and biventricular correction has resulted in a decline in neonatal heart transplant volume. However, limited reports on neonatal heart transplants have demonstrated favorable outcomes. We report the long-term outcomes of patients with neonatal heart transplants at our institution spanning nearly 30 years. ⋯ Our institution reports favorable outcomes of neonatal heart transplantation. These results should be considered within the context of outcomes for patients awaiting transplant and the limited donor availability. However, the successful nature of these procedures suggest it may be necessary to reevaluate the indications for neonatal heart transplantation, particularly where risk of mortality and morbidity with palliative or corrective surgery is high.
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J. Thorac. Cardiovasc. Surg. · Nov 2021
Observational StudyThe impact of additional antegrade pulmonary blood flow at bidirectional Glenn shunt on long-term outcomes.
We investigated the impact of additional antegrade pulmonary blood flow on the long-term outcomes after bidirectional Glenn shunt. ⋯ Maintaining antegrade pulmonary blood flow at bidirectional Glenn shunt was beneficial for higher oxygen saturation and larger pulmonary artery size before Fontan operation. However, it was unfavorable for overall transplant-free survival with a sustained higher risk of death or transplant until the elimination of antegrade pulmonary blood flow.
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J. Thorac. Cardiovasc. Surg. · Nov 2021
Esophageal adenocarcinoma with any component of signet ring cells portends poor prognosis and response to neoadjuvant therapy.
Multiple investigations have shown inferior outcomes for esophageal cancer patients with signet ring cell (SRC) histology. Traditionally, SRC adenocarcinoma has been defined by ≥50% of the tumor composed of SRC. We hypothesized that patients with SRC even <50% would show resistance to standard multimodality therapy with poorer long-term outcomes. ⋯ We present the only known evaluation of the percentage of SRC component in esophageal carcinoma. Our data support the hypothesis that esophageal adenocarcinoma with any component of SRC are more resistant to chemoradiation with poorer survival. Pathologic reporting of esophageal adenocarcinoma should include any component of SRC. Alternative therapies in patients with any SRC component may be indicated.