The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Mar 2013
Comparative StudyMinimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: a propensity-matched comparison.
Minimally invasive approaches to mitral valve surgery are increasingly used, but the surgical approach must not compromise the clinical outcome for improved cosmesis. We examined the outcomes of mitral repair performed through right minithoracotomy or median sternotomy. ⋯ In appropriate patients with isolated mitral valve disease of any cause, a right minithoracotomy approach may be used without compromising clinical outcome.
-
J. Thorac. Cardiovasc. Surg. · Mar 2013
The influence of preoperative serum anticholinergic activity and other risk factors for the development of postoperative cognitive dysfunction after cardiac surgery.
Patients undergoing cardiac surgery are at risk for postoperative cognitive dysfunction (POCD). Evaluating preoperative risk factors represents 1 possible way to minimize the postoperative risk of cognitive dysfunction. We investigated marked deterioration in cholinergic neurotransmission as 1 such potential risk factor for transient and long-lasting POCD. Serum anticholinergic activity (SAA) has already been described as a risk factor for developing delirium in an elderly study population. However, the role of SAA for long-lasting POCD is unknown. ⋯ Preoperatively increased SAA did not predict POCD 3 months after cardiac surgery.
-
J. Thorac. Cardiovasc. Surg. · Mar 2013
Update on blunt thoracic aortic injury: fifteen-year single-institution experience.
Despite improvements in the management of blunt thoracic aortic injury, mortality remains high. We report our experience with blunt thoracic aortic injury at a level 1 trauma center over the past 15 years. ⋯ Blunt thoracic aortic injury remains associated with significant early mortality. Delayed selective management, when applied with open repair with distal aortic perfusion and the use of thoracic endovascular aortic repair, has been associated with improved early outcomes. The long-term durability of thoracic endovascular aortic repair is unknown, necessitating close radiographic follow-up.
-
J. Thorac. Cardiovasc. Surg. · Mar 2013
Treatment of aortic arch aneurysms with a modular transfemoral multibranched stent-graft: initial experience.
To present an initial experience with a new modular transfemoral multibranched stent-graft for treating aortic arch aneurysms. ⋯ We have demonstrated the technical feasibility of a modular transfemoral branched stent-graft for treatment of aortic arch aneurysms. Our initial experience has shown that the method is relatively safe. Long-term follow-up is necessary to evaluate the efficacy and safety of this new device.
-
J. Thorac. Cardiovasc. Surg. · Mar 2013
Contemporary outcomes of surgical ventricular septal defect closure.
Surgical closure of ventricular septal defects remains the most common pediatric cardiac surgical procedure. No studies, however, have comprehensively analyzed risk factors and drivers of nonmortality outcomes in the current era. The purpose of this study was to assess both baseline characteristics and outcomes of children undergoing surgical repair of ventricular septal defects in a contemporary cohort. ⋯ Even in the current surgical era, weight remains a significant predictor of morbidity and driver or length of stay in young infants undergoing ventricular septal defect closure. Weight still should be considered when discussing operative risks for children younger than age 6 months undergoing this procedure, irrespective of the indication for operation.