The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative Study Observational StudyInsurance status predicts acuity of thoracic aortic operations.
Nonelective case status is the strongest predictor of mortality for thoracic aortic operations. We hypothesized that underinsured patients were more likely to require nonelective thoracic aortic surgery because of reduced access to preventative cardiovascular care and elective surgical services. ⋯ Underinsured patients were at the greatest risk of requiring nonelective thoracic aortic operation, possibly because of decreased use of lipid-lowering therapies and aortic surveillance. These data imply that greater access to preventative cardiovascular care may reduce the need for nonelective thoracic aortic surgery and lead to improved survival from thoracic aortic disease.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Multicenter StudyRisk factors for mortality and failure of conservative treatment after aortic type B dissection.
Despite medical treatment, one third of patients with uncomplicated type B aortic dissections experience severe late complications. The aim of this study was to identify patients at high risk of mortality during follow-up. ⋯ Our study revealed both early aortic dilatation and older age as risk factors for increased mortality after conservative treatment of type B dissection.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyIncidence and outcomes of right-sided endocarditis in patients with congenital heart disease after surgical or transcatheter pulmonary valve implantation.
To evaluate right-sided endocarditis and compare the incidence, clinical presentations, and outcomes in patients with a surgical and percutaneous pulmonary valve. ⋯ There is a higher incidence of endocarditis in patients with PPVI compared with surgical pulmonary valves. Clinical and biological features were comparable in both groups. The role of bovine jugular veins in the development of endocarditis is concerning. However, despite a higher incidence of endocarditis in the PPVI group, the probabilities of survival and event-free survival were similar to the surgical group.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Multicenter Study Comparative Study Observational StudySystemic chemotherapy in combination with pericardial window has better outcomes in malignant pericardial effusions.
Our aim was to compare systemic chemotherapy (CT) with drainage and with pericardial window in the treatment of neoplastic pericarditis in patients with various malignancies included in the International Neoplastic Pericarditis Treatment study. ⋯ Systemic CT plus pericardial window is a more effective treatment option compared with systemic CT alone and systemic CT plus drainage in patients with malignant effusions.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Neurologic and psycho-intellectual outcome related to structural brain imaging in adolescents and young adults after neonatal arterial switch operation for transposition of the great arteries.
We studied brain structure abnormalities in adolescents and young adults who had undergone the neonatal arterial switch operation for transposition of the great arteries and related them to the neurologic and psycho-intellectual outcomes. ⋯ Despite encouraging overall neurodevelopmental outcomes, a significant minority had performances below the expected level, emphasizing the need for ongoing surveillance. Considering the high frequency of structural brain abnormalities, prospective long-term studies are needed to define their prognostic value with respect to the neuropsychological outcomes in childhood and adolescence.