The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Surgical outcomes of 380 patients with double outlet right ventricle who underwent biventricular repair.
The study objective was to report the outcomes of biventricular repair in patients with double outlet right ventricle. ⋯ Optimal results of varied types of biventricular repair for double outlet right ventricle have been acquired. Although noncommitted ventricular septal defect is technically difficult, the outcomes of patients are favorable. Late-onset left ventricular outflow tract obstruction is the main reason for reoperation but can be successfully relieved by the modified Konno procedure.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Comparative StudyManagement of mitral regurgitation in Marfan syndrome: Outcomes of valve repair versus replacement and comparison with myxomatous mitral valve disease.
The study objective was to evaluate patients with Marfan syndrome and mitral valve regurgitation undergoing valve repair or replacement and to compare them with patients undergoing repair for myxomatous mitral valve disease. ⋯ Patients with Marfan syndrome and mitral regurgitation have better survival with repair than with replacement. Survival and risk of reoperation for patients with Marfan syndrome were similar to those for patients with myxomatous mitral disease. These results support the use of mitral valve repair in patients with Marfan syndrome and moderate or more mitral regurgitation, including those having composite replacement of the aortic root.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Genetically engineered pigs and target-specific immunomodulation provide significant graft survival and hope for clinical cardiac xenotransplantation.
Cardiac transplantation and available mechanical alternatives are the only possible solutions for end-stage cardiac disease. Unfortunately, because of the limited supply of human organs, xenotransplantation may be the ideal method to overcome this shortage. We have recently seen significant prolongation of heterotopic cardiac xenograft survival from 3 to 12 months and beyond. ⋯ Genetically engineered pig hearts (GTKOhTg.hCD46.hTBM) with modified targeted immunosuppression (anti-CD40 monoclonal antibody) achieved long-term cardiac xenograft survival. This potentially paves the way for clinical xenotransplantation if similar survival can be reproduced in an orthotopic transplantation model.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
The impact of hospital and surgeon volume on the 30-day mortality of lung cancer surgery: A nation-based reappraisal.
Our objective was to analyze the time trend variation of 30-day mortality after lung cancer surgery, and to quantify the impact of surgeon and hospital volumes over a 5-year period in France. ⋯ Since 2007, when France's first National Cancer Plan became effective, 30-day mortality of primary lung cancer surgery has decreased and currently measures 3.8%. Low mortality was correlated with higher surgeon volume but was not influenced by hospital volume, which cannot be considered a proxy measure for determining the safety of lung cancer surgery.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
An easily calculable and highly predictive risk index for postoperative renal failure after heart transplantation.
This study derived and validated a risk index for postoperative renal failure after orthotopic heart transplantation. ⋯ This 100-point risk index incorporating 13 risk factors is highly predictive of new-onset postoperative renal failure after orthotopic heart transplantation. Prospective assessment of orthotopic heart transplant recipients using the risk categories that were generated on the basis of score ranges may help in tailoring perioperative management.