The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Occluded Fenestration is Associated with Improved Long-Term Outcomes in Patients Undergoing the Fenestrated Fontan Operation.
The modified Fontan operation, a palliative approach for patients with single ventricular circulation, often incorporates a fenestration to facilitate postoperative management. Postoperative fenestration closure sometimes is performed to mitigate potential risks such as low oxygen saturation. However, the benefits and potential risks of this procedure remain under investigation. ⋯ Patients with occluded fenestration exhibited superior event-free survival. Fenestration closure is a feasible strategy to enhance oxygen saturation without elevating Fontan pressure.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Transcatheter versus Surgical Aortic Valve Replacement in Patients Younger than 65 Years in the US.
To characterize trends and outcomes of aortic valve replacement in patients <65 with aortic stenosis between 2013 and 2021. ⋯ Despite clinical guidelines, the utilization of TAVR has increased in patients <65. TAVR in this population is associated with a higher 6-year mortality and a higher rate of new permanent pacemaker implantation when compared to a matched cohort treated with biologic SAVR. These findings support the need for a randomized controlled trial comparing long-term outcomes of TAVR versus SAVR in patients <65.