The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Adoption of a Semi-elective Lung Transplantation Practice by Safely Extending Cold Ischemic Times.
Lung transplantation is a complex surgical procedure performed by specialized teams. Practice changes to eliminate overnight lung transplants were implemented at our center and patient outcomes were evaluated. ⋯ Donor lungs preserved in an iceless cooler were successfully transplanted after extended cold ischemic times. Adoption of a semi-elective transplant strategy can be successfully implemented without compromising patient outcomes. Additional advantages may be gleaned through daytime transplantation with standard transplant surgical teams rather than overnight, on call-teams.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Clinical features and postoperative outcomes in elderly patients undergoing septal myectomy for hypertrophic cardiomyopathy.
Surgical septal reduction is sometimes avoided in older adults due to anticipated high operative risk. The study objectives were to compare the clinical and echocardiographic characteristics of young and older patients undergoing septal myectomy for obstructive hypertrophic cardiomyopathy and assess differences in early and late postoperative outcomes. ⋯ Clinical characteristics of obstructive hypertrophic cardiomyopathy in older patients differ from those in younger patients. More symmetric but less extensive ventricular hypertrophy and less positive genetic testing suggests that hypertrophic cardiomyopathy has distinct clinical and morphological variants in the elderly. Septal myectomy is safe in older patients, but the presence of left ventricular wall asymmetry portends a poorer prognosis.