The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2021
David reimplantation with simultaneous total arch replacement and stented elephant trunk for acute type A aortic dissection.
To compare early and mid-term outcomes between David reimplantation and the Bentall procedure with simultaneous total arch replacement (TAR) and stented elephant trunk (SET) implantation in acute type A aortic dissection (ATAAD). ⋯ For Chinese patients undergoing ATAAD, David reimplantation provided similar outcomes compared with the Bentall procedure, with simultaneous TAR and SET. David reimplantation is an appealing option for patients who suffer root ectasia or extensive sinus damage albeit normal leaflets.
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J. Thorac. Cardiovasc. Surg. · Jun 2021
Multicenter StudyGeriatric assessment in the prediction of delirium and long-term survival after transcatheter aortic valve implantation.
Transcatheter aortic valve implantation (TAVI) has emerged as the preferred management strategy for elderly patients with severe symptomatic aortic valve stenosis. These patients are often at high risk of postoperative delirium (POD), which is associated with morbidity and mortality. Since POD may be prevented in a considerable part of these patients, identification of patients at risk is essential. The aim of current study was to identify geriatric assessment tools associated with delirium after TAVI, and long-term mortality. ⋯ This study shows that impaired mobility is currently the best single predictor for POD and 2-year mortality in high-risk patients undergoing TAVI. Prospective multicenter studies are needed to optimize and to further explore the facilitation of routine use of POD predictors in TAVI pathways of care, and subsequent preventive interventions.
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J. Thorac. Cardiovasc. Surg. · Jun 2021
Outcomes following surgery for primary mediastinal nonseminomatous germ cell tumors in the cisplatin era.
Treatment of primary mediastinal nonseminomatous germ cell tumors involves cisplatin-based chemotherapy followed by surgery to remove residual disease. We undertook a study to determine short and long-term outcomes. ⋯ In the treatment of primary mediastinal nonseminomatous germ cell tumors, avoiding bleomycin-containing chemotherapy is important. Pre- and postchemotherapy pathology and postoperative serum tumor markers are independent predictors of long-term survival.
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J. Thorac. Cardiovasc. Surg. · Jun 2021
The relationship of atrial fibrillation and tricuspid annular dilation to late tricuspid regurgitation in patients with degenerative mitral repair.
Guidelines do not address preoperative atrial fibrillation when considering adding tricuspid annuloplasty to mitral surgery. Our purpose was to determine the occurrence of late tricuspid regurgitation in patients with less than moderate tricuspid regurgitation undergoing surgery for degenerative mitral regurgitation and the importance of atrial fibrillation and tricuspid annular dilation. ⋯ Preoperative atrial fibrillation is an important risk factor for late tricuspid regurgitation despite concomitant ablation surgery. Tricuspid annular dilation was not associated with late tricuspid regurgitation until the annulus was 45 mm or greater. Progression to moderate or greater tricuspid regurgitation was associated with an increase in late mortality.