The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Chest wall resection and reconstruction for primary chest wall sarcomas: analysis of survival, predictors of outcome and long-term functional status.
We aimed to analyze survival, predictors of outcome and the long-term functional status of patients with a diagnosis of primary chest wall sarcoma who undergo chest wall resection and reconstruction (CWRR). ⋯ Careful patient selection and multi-disciplinary decision-making is crucial. This leads to clear resection margins, good overall and disease-free survival and good functional outcomes.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
The Impact of Blood Type and Body Size on Successful Bridging to Heart Transplantation using Intraaortic Balloon Pump or Surgically Implanted Microaxial Left Ventricular Assist Device.
Waitlist time for UNOS Status 2 heart transplantation (HTx) candidates has steadily increased. We compared a bridging strategy using either Impella 5.0/5.5 ("Impella") or intra-aortic balloon pump (IABP) to durable LVAD in blood type O patients, stratified by body habitus. ⋯ Blood type O candidates listed with Impella or IABP are at increased risk of post-listing mortality compared to durable LVAD in the current organ allocation era. These effects are diminished among those with normal height and body habitus.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Do Non-fatal MACCE In The First 5-years Post CABG Affect 10-year Outcomes?
Few have examined the impact of early adverse events post coronary artery bypass grafting (CABG) on long-term survival. We sought to determine if the occurrence of non-fatal major adverse cardiac and cerebrovascular events (MACCE) in the first 5 years after CABG impacts survival and adverse events at 10 years. ⋯ Patients who experienced non-fatal MACCE in the first 5-year after CABG experienced worse survival and more MACCE at 10 years. Prevention of major adverse events in the first five years after surgical revascularization may be an important strategy to improve late outcomes.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Impact of the Grade and Jet-flow Direction of Residual Aortic Regurgitation after Valve-Sparing Root Replacement.
The current study aimed to investigate the impact of the grade and jet direction of residual aortic regurgitation (rAR) after valve-sparing root replacement (VSRR). ⋯ rAR after VSRR operation could be a risk factor for AR progression. Minimal central rAR generally has a tolerable clinical course. However, patients with even minimal eccentric AR may develop AR progression, so active surveillance and timely management might be required. Further, early VSRR can help reduce the rAR.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Elective Root Replacement Increases the Risk of Type B Dissection in Patients with Marfan Syndrome.
Marfan syndrome (MFS) is a genetic disorder with increased risk of aortic dissection. Currently, type A aortic dissection risk is mitigated by aortic root replacement with Dacron. It is unclear if root replacement increases the risk of distal aortic disease given the non-compliant nature of Dacron. ⋯ Marfan syndrome patients who undergo elective aortic root replacement appear to have a higher incidence of subsequent type B aortic dissection, independent of other risk factors. Careful consideration must be made to the management of the distal aorta in MFS patients who undergo root replacement.