The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Selective sinus replacement for aortic root repair in bicuspid aortopathy.
To evaluate the results after selective sinus replacement (SSR) for aortic root remodeling in bicuspid aortopathy. ⋯ Patient-tailored root repair using SSR is a very effective and durable valve-sparing approach for bicuspid aortopathy. Aortic cusp repair is decisive for both abolishment of AI in bicuspid aortopathy and for the functional durability of the repaired aortic valve.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Extending the Age Criteria of Lung Transplant Donors to 70+ years old Does Not Significantly Affect Recipient Survival.
To determine the impact of older donor age (70+ years) on long-term survival and freedom from chronic lung allograft dysfunction in lung transplant (LTx) recipients. ⋯ Lung transplantation using donors 70 years old or older can be considered when all other parameters suggest excellent donor lung function without compromising short- or long-term outcomes.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Efficacy of del Nido cardioplegia in adult cardiac procedures with prolonged aortic crossclamp time.
Equivalent myocardial protection and clinical outcomes have been shown with the use of del Nido cardioplegia (DC) compared with blood cardioplegia (BC) in adult isolated coronary artery bypass grafting and valve patients. However, its safety and efficacy in cardiac procedures with aortic crossclamp times >90 minutes is still unknown. ⋯ In adult cardiac surgical procedures with aortic crossclamp times >90 minutes, comparable myocardial protection, perioperative mortality and morbidity, and distant survival were observed with the use of DC compared with BC. Higher troponin levels were seen in DC patients with crossclamp times between 150 and 180 minutes, but this was not associated with increased mortality.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Lung Surveillance following Colorectal Cancer Pulmonary Metastasectomy: Utilization of Clinicopathologic Risk Factors to Guide Strategy.
Appropriately selected patients clearly benefit from resection of colorectal cancer (CRC) pulmonary metastases (PMs). However, there remains equipoise surrounding optimal chest surveillance strategies following pulmonary metastasectomy. We aimed to identify risk factors that may inform chest surveillance in this population. ⋯ Patients with KRAS alterations, TP53 alterations, and no APC alterations developed early recurrence in the lung following pulmonary metastasectomy, as did those who received chemotherapy after their initial PM diagnosis. As such, these groups benefit from early lung imaging after metastasectomy, as chest surveillance protocols should be based on patient-centered clinicopathologic and genomic risk factors.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Smaller rectus femoris size measured by ultrasound is associated with poorer outcomes after cardiac surgery.
We sought to evaluate the association of low rectus femoris cross-sectional area (RFCSA) with hospital length of stay and poorer outcomes in patients undergoing cardiac surgery. ⋯ Low RFCSA has a significant association with increased hospital length of stay, morbidity, and nonhome discharge in patients undergoing cardiac procedures.