The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Meta AnalysisCoronary surgery provides better survival than drug eluting stent: a pooled meta-analysis of Kaplan-Meier-derived individual patient data.
We explored the current evidence on coronary disease treatment comparing the survival of 2 therapeutic strategies: coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stent (DES). ⋯ The present meta-analysis suggests that CABG provides a consistent survival benefit over PCI with DES.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Randomized Controlled Trial Multicenter StudyPacemaker implantation associated with tricuspid repair in the setting of mitral valve surgery: Insights from a Cardiothoracic Surgical Trials Network randomized trial.
In a recent trial, tricuspid annuloplasty (TA) during mitral valve surgery (MVS) for degenerative mitral regurgitation and moderate or less tricuspid regurgitation (TR) reduced the composite rate of death, reoperation for TR, or TR progression at 2 years. However, this benefit was counterbalanced by an increase in implantation of permanent pacemakers (PPMs). In this study, we analyzed the timing, indications, and risk factors for these implantations. ⋯ Concomitant TA, age, and baseline LVEF were risk factors for PPM implantation in patients who underwent MVS for degenerative mitral regurgitation. Although TA was effective in preventing progression of TR, innovation is needed to identify ways to decrease PPM implantation rates.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Comparative StudyEarly and long-term outcomes of bioprosthetic versus mechanical tricuspid valve replacement: A nationwide population-based study.
We compared early and long-term clinical outcomes of bioprosthetic versus mechanical tricuspid valve replacement in a nationwide study based on the database from the National Health Insurance Service. ⋯ Mechanical tricuspid valve replacement demonstrated higher long-term survival than bioprosthetic tricuspid valve replacement. In particular, mechanical tricuspid valve replacement showed significantly higher overall survival between 54 and 65 years of age.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Comparative Study Observational StudyPreservation versus replacement of the aortic root for acute type A aortic dissection.
To determine the impact of aortic root preservation versus aortic root replacement (ARR) after acute type A aortic dissection (ATAAD) repair. ⋯ These findings suggest that aortic root preservation may achieve similar midterm outcomes as ARR after ATAAD repair.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Efficacy of opioid-sparing analgesia after median sternotomy with continuous bilateral parasternal subpectoral plane blocks.
Regional anesthetic techniques, traditionally underutilized in cardiac surgery, may play a role in multimodal analgesia, effectively improving pain control and reducing opioid consumption. We investigated the efficacy of continuous bilateral ultrasound-guided parasternal subpectoral plane blocks following sternotomy. ⋯ Continuous bilateral parasternal subpectoral plane blocks may further reduce poststernotomy pain and opioid consumption within the context ERAS multimodal analgesia.