The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Use of balloon expandable transcatheter valves for valve-in-valve implantation in patients with degenerative stentless aortic bioprostheses: Technical considerations and results.
Transcatheter valve-in-valve is an accepted treatment in high-risk patients with degenerative stented bioprostheses in the aortic position. Experience in treating stentless valves is, however, limited. Our aim was to determine the feasibility and single-center outcome of balloon expandable SAPIEN valve placement in degenerated stentless aortic valve bioprostheses. ⋯ Transcatheter aortic valve implantation after previous stentless aortic valve replacement is technically demanding but a safe and feasible approach. The early results were excellent, with consistent improvement in hemodynamics. Prospective long-term follow-up in larger series is needed to evaluate this technique further.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Aortic valve reconstruction using autologous pericardium for patients aged less than 60 years.
We have performed an original aortic valve reconstruction using autologous pericardium. The feasibility for patients aged less than 60 years is reviewed. ⋯ Original aortic valve reconstruction was feasible for patients aged less than 60 years. Long-term data will be disclosed in the future.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Transesophageal pulmonary nodule biopsy using endoscopic ultrasonography.
Parenchymal pulmonary nodules located in proximity to the mediastinum, vertebral column, major vessels, or behind the heart can be technically challenging and dangerous to biopsy using traditional image-guided techniques. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) can be used to access some of these difficult to reach lesions. The purpose of the present study was to report our experience with this technique in a consecutive cohort of selected patients. ⋯ EUS-FNA of parenchymal pulmonary nodules is safe and accurate and allows for biopsy of perimediastinal lung lesions not attainable using traditional techniques.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Long-term outcomes after definitive repair for tetralogy of Fallot with preservation of the pulmonary valve annulus.
The aim of our study was to evaluate the long-term outcomes after definitive repair of tetralogy of Fallot with preservation of the pulmonary valve (PV) annulus. ⋯ The long-term outcomes after definitive repair of tetralogy of Fallot with preservation of the PV annulus were excellent. Although isolated, monofocal premature ventricular contractions were frequently observed, fatal ventricular arrhythmia was not. The indication should not only be decided by the PV annulus size, but also by the valvular morphology to maintain long-term PV competency.
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J. Thorac. Cardiovasc. Surg. · Sep 2014
Topical vancomycin in combination with perioperative antibiotics and tight glycemic control helps to eliminate sternal wound infections.
This study was undertaken to determine whether topical vancomycin would further reduce the incidence of sternal infections in the presence of perioperative antibiotics and tight glycemic control. ⋯ Topical vancomycin applied to the sternal edges, in conjunction with perioperative antibiotics and tight glycemic control, helps to eliminate wound infections in cardiac surgical patients.