The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Concomitant aortic and mitral surgery: to replace or repair the mitral valve?
The study objectives were to evaluate the perioperative outcomes of concomitant mitral and aortic valve surgery and to determine the influence of mitral valve repair versus replacement on survival and adverse events. ⋯ Concomitant mitral and aortic valve surgery carries a low surgical risk. The choice of the mitral procedure did not significantly affect survival. However, mitral valve replacement was associated with an increased incidence of adverse events. Thus, valve repair, whenever feasible, is a better option.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Mitral valve repair versus replacement in the elderly: short-term and long-term outcomes.
To compare the short-term and long-term outcomes of mitral valve repair (MVP) versus mitral valve replacement (MVR) in elderly patients. ⋯ Elderly patients with mitral regurgitation who undergo MVP have better postoperative outcomes, lower operative mortality, and improved long-term survival than those undergoing MVR. MVP is a safe and more effective option for the elderly with mitral regurgitation.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Clinical significance and determinants of the universal definition of perioperative bleeding classification in patients undergoing coronary artery bypass surgery.
We evaluated the clinical significance and identified the predictors of the universal definition of perioperative bleeding (UDPB) classes in patients undergoing isolated coronary artery bypass grafting (CABG). ⋯ High UDPB classes were associated with significantly poorer immediate and late outcomes. The UDPB classification seems to be a valuable research tool to estimate the severity of bleeding and its prognostic impact affect after coronary surgery.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Improving interstage survival after Norwood operation: outcomes from 10 years of home monitoring.
Infants who undergo Norwood stage 1 palliation (S1P) continue with high-risk circulation until stage 2 palliation (S2P). Routine care during the interstage period is associated with 10% to 20% mortality. This report illustrates the sustained reduction of interstage mortality over 10 years associated with use of home monitoring. ⋯ Home monitoring after S1P is associated with excellent interstage survival. Although a breach of monitoring criteria occurred in more than half of patients, our analysis failed to identify independent predictors of interstage events. Analysis of variables predicting mortality could not be assessed due to the low frequency of death in this cohort. Failure to identify specific variables for interstage events suggests that home monitoring, as part of an interstage surveillance program, should be applied to all S1P hospital survivors.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Fate of functional tricuspid regurgitation in aortic stenosis after aortic valve replacement.
Functional tricuspid regurgitation (TR) is found not infrequently in conjunction with aortic stenosis. The aim of the present study was to evaluate the changes in TR and to identify the predictors of late progression after aortic valve replacement. ⋯ Not only did TR in patients with aortic stenosis frequently persist after aortic valve replacement, it was progressive in some. This finding was associated with left ventricular diastolic dysfunction. A concomitant tricuspid valve procedure could be considered in selected patients with aortic stenosis to avoid late TR.