The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2023
A uniform strategy of primary repair of tetralogy of Fallot - Transventricular approach results in low reoperation rate in the first decade.
To review outcomes after a uniform strategy of transventricular repair of tetralogy of Fallot. ⋯ A uniform strategy of primary repair of tetralogy of Fallot through a transventricular approach resulted in low reoperation rate in the first decade. The need of pulmonary valve implantation was limited to <4% at 10 years.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Aortic regurgitation provokes phenotypic modulation of smooth muscle cells in the normal ascending aorta.
Aortic complications are more likely to occur in patients with ascending aortic aneurysms and concomitant aortic regurgitation (AR). AR may have a negative influence on the aortic wall structure even in patients with tricuspid aortic valves and absence of aortic dilatation. It is unknown whether smooth muscle cell (SMC) changes are a feature of AR-associated aortic remodeling. ⋯ AR itself negatively influences SMC phenotype in the ascending aortic wall. This AR-specific effect is independent of aortic diameter and aortic valve morphology, although it is more pronounced with bicuspid aortic valves. These findings provide insight into the mechanisms of AR-related aortic remodeling, and they provide a model for studying SMC-specific therapies in culture.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Effect of ascending aorta replacement on the long-term outcomes of bicuspid aortic valve repair.
The study objective was to determine the effect of sinutubular junction stabilization on long-term outcomes of bicuspid aortic valve repair. ⋯ Bicuspid aortic valve repair with or without ascending aorta replacement is associated with good short- and long-term outcomes. Bicuspid aortic valve repair + ascending aorta replacement has a minimal effect on long-term repair durability. Sinutubular junction stabilization should not be performed for the sole purpose of long-term repair durability.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Molecular characterization and clinical investigation of patients with heritable thoracic aortic aneurysm and dissection.
Thoracic aortic aneurysm and dissection has a genetic predisposition and a variety of clinical manifestations. This study aimed to investigate the clinical and molecular characterizations of patients with thoracic aortic aneurysm and dissection and further explore the relationship between the genotype and phenotype, as well as their postoperative outcomes. ⋯ Our data expanded the genetic spectrum of heritable thoracic aortic aneurysm and dissection and indicated that copy number variations and mosaic variants contributed to a small proportion of the disease-causing alterations. Moreover, positive genetic results might have a possible predictive value for aortic event severity and postoperative risk stratification.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Quantifying the effects of circulatory arrest on acute kidney injury in aortic surgery.
We aim to investigate the association between parameters surrounding circulatory arrest and postoperative acute kidney injury in aortic surgery. ⋯ Within the range of our clinical practice, prolonged lower-body ischemia duration was not independently associated with postoperative acute kidney injury, whereas nadir temperature was.