The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2013
Multicenter StudyAdvantage of a precurved fenestrated endograft for aortic arch disease: simplified arch aneurysm treatment in Japan 2010 and 2011.
We evaluated the results of our previous study investigating a precurved fenestrated endograft treatment for thoracic aortic aneurysms and aortic dissection extended to the aortic arch. ⋯ A precurved fenestrated endograft for endovascular repair in aortic arch disease rendered catheter manipulation simple and minimized operative complication risks. Although most patients had inadequate proximal landing zone and severely angled complex configuration, low mortality and morbidity and satisfactory clinical success were early outcomes, suggesting that this simplified treatment may be effective for aortic arch disease.
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J. Thorac. Cardiovasc. Surg. · Mar 2013
Multicenter StudyBlood product conservation is associated with improved outcomes and reduced costs after cardiac surgery.
Efforts to reduce blood product use have the potential to avoid transfusion-related complications and reduce health care costs. The purpose of this investigation was to determine whether a multi-institutional effort to reduce blood product use affects postoperative events after cardiac surgical operations and to determine the influence of perioperative transfusion on risk-adjusted outcomes. ⋯ Implementation of a blood use initiative significantly improves postoperative morbidity, mortality, and resource utilization. Limiting intraoperative and postoperative blood product transfusion decreases adverse postoperative events and reduces health care costs. Blood conservation efforts are bolstered by collaboration and guideline development.
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J. Thorac. Cardiovasc. Surg. · Mar 2013
Surgical and neurologic outcomes after robotic thymectomy in 100 consecutive patients with myasthenia gravis.
Thymectomy is a well-defined therapeutic option for patients with myasthenia gravis; however, controversies still exist about the surgical approach, indication, and timing for surgery. We reviewed our experience reporting surgical and neurologic results after robotic thymectomy in patients with myasthenia gravis. ⋯ Robotic thymectomy is a safe and effective procedure. We observed a neurologic benefit in a great number of patients. A better clinical outcome was obtained in patients with early Myasthenia Gravis Foundation of America class.
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J. Thorac. Cardiovasc. Surg. · Mar 2013
Intra/extracardiac fenestrated modification leads to lower incidence of arrhythmias after the Fontan operation.
The study objective was to compare the incidence of short- and intermediate-term arrhythmias among 3 different surgical modifications of the Fontan procedure. ⋯ Intra/extracardiac conduit with limited atriotomy Fontan modification has a significantly lower risk of abnormal rhythm postoperatively in the short and intermediate term when compared with the lateral tunnel.
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J. Thorac. Cardiovasc. Surg. · Mar 2013
Hybrid three-stage repair of mega aorta syndrome with the Lupiae technique.
Open surgical replacement of the whole aorta in mega aorta syndrome remains a surgical challenge. We report our experience in the treatment of patients with mega aorta syndrome using a 3-stage hybrid repair. ⋯ Our hybrid 3-stage approach seems to be effective in the treatment of mega aorta syndrome. The second stage was affected by non-negligible rates of perioperative complications. The overall mid-term results were encouraging, although a larger sample size with longer follow-up is needed to compare this technique with others.