The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Durability of Annuloplasty in Patients with Atrial Functional Mitral Regurgitation Associated with Atrial Fibrillation.
To determine the durability of mitral valve repair (MVr) with complete ring or flexible band annuloplasty in patients with atrial functional mitral regurgitation (AFMR) due to atrial fibrillation (AF) and identify risk factors associated with postoperative recurrence of mitral regurgitation. ⋯ In appropriate patients with AFMR, the long-term durability of annuloplasty is excellent with complete ring and posterior band annuloplasty techniques.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Scoring System to Predict Mid-term Adverse Events after Elective Thoracic Endovascular Aortic Repair.
To develop and validate a scoring system to predict mid-term adverse events after elective thoracic endovascular aortic repair (TEVAR). ⋯ Although external validation is needed, our scoring system may be useful for decision making, especially in patients with an intact thoracic aortic aneurysm.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Reoperative Aortic Root Replacement Following Previous Cardiac Surgery or Type A Aortic Dissection Repair.
Reoperative aortic root replacement (ARR) is a technically challenging procedure. This study assesses the influence of reoperation on outcomes following ARR, particularly after prior acute type A aortic dissection repair. ⋯ Patients undergoing reoperative ARR have more comorbidities and extensive aortic disease compared with those undergoing primary surgery. They face a 3.5-fold increased risk of major adverse events but no difference in operative mortality compared with primary ARR.
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J. Thorac. Cardiovasc. Surg. · Aug 2024
Heart-Liver Transplantation Utilizing the En Bloc Technique: A Single-Center Experience Over Two Decades.
Combined heart-liver transplantation (CHLT) is a definitive therapy reserved for patients with concomitant heart failure and advanced liver disease. A limited number of centers perform CHLT, and even fewer use the en bloc implantation technique. Here we review clinical outcomes and immunoprotective effects following CHLT and describe our institution's more than two decades of experience in performing the en bloc technique. ⋯ CHLT is a definitive therapy reserved for patients with multiorgan dysfunction. At our institution, the en bloc technique is the preferred operative approach, as it minimizes cardiac insult, requires fewer anastomoses, minimizes cold ischemia time, and allows for rapid correction of coagulopathy. Overall survival for this cohort is excellent. Episodes of acute rejection were rare, providing further support for the idea that the liver may serve an immunoprotective role in multiorgan transplantation.