The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Direct Procurement with Machine Perfusion and Normothermic Regional Perfusion in Donation after Circulatory Death Heart Transplantation.
Donation after circulatory death (DCD) heart transplants have increased in the United States with direct procurement with machine perfusion (DPP) and thoracoabdominal normothermic regional perfusion (TA-NRP) techniques. There remains a paucity of data examining DPP and TA-NRP outcomes. The purpose of this study was to investigate the impact of the DCD technique on post-transplant outcomes compared to donation after brain death (DBD) donors. ⋯ In this matched cohort, DCD heart recipients experienced increased acute rejection, both treated and nontreated, compared to DBD heart recipients. Despite differences in the techniques and likely in fWIT, acute rejection, survival, and other secondary outcomes are similar with DPP and TA-NRP.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Wide Variation in Mitral Valve Repair Rates Among U.S. Surgeons: Analysis of Medicare Claims Data.
Mitral valve repair is the preferred treatment for primary mitral regurgitation and offers significant short- and long-term advantages over valve replacement. This study was designed to evaluate the contemporary national mitral valve surgery practice patterns, focusing on the impact of surgeon-specific factors, such as operative volume and years of practice, on repair rates. ⋯ This study has identified significant variability in mitral valve repair rates among surgeons who treat Medicare beneficiaries. Notably, even among the surgeons responsible for most of these procedures, the variability in repair rates is pronounced. These findings suggest substantial opportunities to improve outcomes for patients undergoing mitral valve operations in North America.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Durability of Right Ventricular Conduits in the Ross Procedure.
Right ventricular (RV) conduit availability and degeneration are potential limitations of the Ross procedure. Pulmonary homografts are the gold standard, but their limited availability drives the need for alternatives. The aim of this study was to compare results of different RV conduits. ⋯ The incidence of reintervention after 15 years is similar in recipients of homografts, xenografts, and BJV grafts. Interestingly, homografts may fail in the first few years, possibly related to inflammatory phenomena. Thus, the use of xenografts may be an option if homografts are not available.