The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2014
A standardized repair-oriented strategy for mitral insufficiency in infants and children: midterm functional outcomes and predictors of adverse events.
Surgical management of mitral regurgitation (MR) in children remains a challenge because of the heterogeneity of the anatomy, growth potential, and necessity to avoid valve replacement. Our objective was to assess the functional outcomes and prognostic factors of a standardized strategy of mitral valve (MV) repair for children with MR. ⋯ A standardized and reproducible MV repair strategy can achieve satisfactory functional results in infants and children with severe MR, allowing native valve preservation. The left ventricular outflow tract obstruction-related etiology was the main independent predictor of recurrent MR, MV reoperation, and MV replacement.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Congestive hepatopathy after Fontan operation and related factors assessed by transient elastography.
Congestive hepatopathy after a Fontan operation can have a major effect on long-term morbidity. We evaluated congestive hepatopathy in patients with Fontan circulation using transient elastography to determine which risk factors for hepatopathy are related to liver stiffness (LS). ⋯ The present study revealed that congestive hepatopathy developed in a significant fraction of patients with long-term Fontan circulation and that transient elastography could be an easy and useful method to assess congestive hepatopathy in these patients.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Midterm follow-up of the reimplantation technique in patients with relatively normal annulus: is David I still a clinically valid option?
The aim of this study was to evaluate the midterm results of the reimplantation technique with a straight tubular graft in patients with aortic root aneurysms with or without aortic insufficiency. ⋯ The reimplantation procedure using a straight tube is a safe and reproducible valve-sparing technique that can achieve no in-hospital mortality and durable midterm results, either in bicuspid or tricuspid valves. Further studies are needed to assess the behavior of repaired valves under physical stress at long-term follow-up.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Propensity score-matched analysis of adjuvant chemotherapy for stage I non-small cell lung cancer.
The aim of this study was to reevaluate the role of adjuvant chemotherapy for patients with stage I non-small cell lung cancer (NSCLC). ⋯ Adjuvant chemotherapy is effective for patients with stage I NSCLC, particularly those with an invasive component larger than 2 cm or those with lymphatic invasion.
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With advances in valve repair and ventricular recruitment strategies, patients initially palliated with single ventricle physiology have been increasingly brought to biventricular circulation. Few data are available on the technical aspects and outcomes after takedown of the superior cavopulmonary anastomosis (bidirectional Glenn [BDG]). We reviewed a single-institutional experience in BDG takedown. ⋯ BDG takedown can be undertaken with a low operative risk and a low incidence of SVC or pulmonary artery stenosis or sinus node dysfunction. Additional follow-up is required to see how the reconstructed SVC grows.