The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Meta AnalysisMeta-Analysis of Phase-Specific Survival After Transcatheter versus Surgical Aortic Valve Replacement from Randomized Control Trials.
Transcatheter aortic valve replacement (TAVR) is an established alternative to surgical aortic valve replacement (SAVR) for severe symptomatic aortic stenosis, although phase-specific survival and cause of death are implicated following these procedures. Herein, we conducted a phase-specific meta-analysis to compare outcomes after TAVR versus SAVR. ⋯ Our analysis demonstrated phase-specific outcomes following TAVR and SAVR.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Multicenter Study Comparative StudyValve-Sparing Root Replacement vs. Composite Valve Graft Root Replacement: Analysis of >1500 Patients from Two Aortic Centers.
The long-term outcomes comparing valve-sparing root replacement, composite valve graft with bioprosthesis, and mechanical prosthesis have yet to be explored. We investigated the long-term survival and reintervention rates after 1 of 3 major aortic root replacements in patients with tricuspid aortic valves and patients with bicuspid aortic valves. ⋯ Valve-sparing root replacement, composite valve graft with mechanical prosthesis, and composite valve graft with bioprosthesis demonstrated excellent 12-year survival, with valve-sparing root replacement associated with better survival. All 3 groups have low incidence of reintervention, with valve-sparing root replacement showing decreased late postoperative need for reintervention compared with composite valve graft with bioprosthesis.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Comparative StudyLong-Term Durability of Valve Sparing Root Replacement in Patients with and without Connective Tissue Disease.
The goal of this study was to evaluate the long-term outcomes of valve-sparing root replacement in patients with connective tissue disease (CTD) and compare them with patients without CTD who underwent valve-sparing root replacement for root aneurysm. ⋯ The operative outcomes as well as long-term durability of valve-sparing root replacement is excellent in patients with or without CTD. Valve function and durability are not influenced by CTD.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Branched Stented Anastamosis Frozen Elephant Trunk Repair (B-SAFER): Early Results from a Physician-sponsored Investigational Device Exemption Study.
Multisegment thoracic aortic disease typically requires total aortic arch replacement, affects a heterogenous population, and carries a high risk even at centers of excellence. Risk has been associated with the duration of operation and complexity of repair. A novel branched stented anastomosis frozen elephant trunk repair (B-SAFER) technique has been developed at our center and is currently being studied as a physician-sponsored investigation device exemption (PS-IDE). ⋯ The B-SAFER technique for total arch replacement in a complex cohort of patients with various indications for surgery is a safe and reproducible operation, as demonstrated by the early results from a very inclusive PS-IDE study. Further follow-up and analysis will help refine the technique. Novel devices to perform this procedure should be developed.