The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2014
In which patients is transcatheter aortic valve replacement potentially better indicated than surgery for redo aortic valve disease? Long-term results of a 10-year surgical experience.
Redo aortic valve replacement procedures have been reduced by the growing practice of trans-catheter aortic valve-in-valve procedures. We analyzed our long-term results of redo aortic valve replacement procedures during a 10-year period in an effort to define subgroups in which trans-catheter aortic valve-in-valve procedures may be better than surgery. ⋯ Redo aortic valve replacement procedures achieves good results, especially in nonendocarditic or elective cases, and young or New York Heart Association functional class I/II patients. Indeed, endocarditis significantly affects outcome. New York Heart Association functional class IV and nonelective procedures might benefit from trans-catheter aortic valve-in-valve procedures.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
A novel emboli protection cannula during cardiac surgery: in vitro results.
Intraoperative cerebral events are mainly caused by emboli generated by operative manipulation of the aorta. This study aimed to delineate the distribution profiles of emboli with 2 widely used cannulae and a third novel research cannula that simultaneously produces forward flow and backward suction to extract emboli from the distal aorta during cardiac surgery. ⋯ A straight-tip cannula may be safer in terms of cerebral embolic consequences during cardiac surgery. Furthermore, the use of the research aortic cannula may be beneficial in the cardiac surgery setting by reducing the postoperative risk for stroke.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
When should a mechanical tricuspid valve replacement be considered?
Isolated mechanical tricuspid valve replacement (mTVR) is uncommon, early mortality is reported to be high, and little is known regarding the long-term outcome. We sought to evaluate the long-term outcome of mTVR. ⋯ Isolated mTVR still leads to increased early mortality. A mechanical valve can be considered in select situations when anticoagulation is necessary and in the presence of good right ventricular function.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Long-term outcomes of concomitant aortic and mitral valve repair.
To evaluate the short- and long-term outcomes of concomitant aortic (AVr) and mitral (MVr) valve repair. ⋯ Concomitant AVr/MVr is associated with acceptable survival and freedom from valve reintervention.
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J. Thorac. Cardiovasc. Surg. · Aug 2014
Observational StudyPulmonary fibrosis on multidetector computed tomography and mortality in patients with radiation-associated cardiac disease undergoing cardiac surgery.
In the long-term, malignancy-associated thoracic radiation leads to varying degrees of pulmonary fibrosis and radiation-associated cardiac disease, often requiring cardiothoracic surgery. We sought to determine whether pulmonary fibrosis affects mortality in patients with radiation-associated cardiac disease undergoing cardiothoracic surgery. ⋯ In patients with radiation-associated cardiac disease undergoing cardiothoracic surgery, worsening pulmonary fibrosis is associated with increased mortality.