The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2012
Transapical aortic valve implantation in patients with severely depressed left ventricular function.
Transapical aortic valve implantation significantly reduces operative risk in elderly patients with aortic valve stenosis and comorbidities. However, it is unknown whether this procedure is feasible in patients with advanced heart failure. ⋯ Transapical aortic valve implantation can be performed safely in patients with decompensated heart failure or even in the presence of cardiogenic shock.
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J. Thorac. Cardiovasc. Surg. · Jun 2012
Pulmonary root translocation in malposition of great arteries repair allows right ventricular outflow tract growth.
Optimal surgical treatment of patients with transposition of the great arteries (TGA), ventricular septal defect (VSD), and pulmonary stenosis (PS) remains a matter of debate. This study evaluated the clinical outcome and right ventricle outflow tract performance in the long-term follow-up of patients subjected to pulmonary root translocation (PRT) as part of their surgical repair. ⋯ PRT is a good surgical alternative for treatment of patients with TGA complexes, VSD, and PS, with acceptable operative risk, high long-term survivals, and few reinterventions. Most patients had adequate pulmonary root growth and performance.
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J. Thorac. Cardiovasc. Surg. · Jun 2012
Randomized Controlled Trial Multicenter Study Comparative StudyOptimal surgical management of severe ischemic mitral regurgitation: to repair or to replace?
Ischemic mitral regurgitation, a complication of myocardial infarction and coronary artery disease more generally, is associated with a high mortality rate and is estimated to affect 2.8 million Americans. With 1-year mortality rates as high as 40%, recent practice guidelines of professional societies recommend repair or replacement, but there remains a lack of conclusive evidence supporting either intervention. The choice between therapeutic options is characterized by the trade-off between reduced operative morbidity and mortality with repair versus a better long-term correction of mitral insufficiency with replacement. The long-term benefits of repair versus replacement remain unknown, which has led to significant variation in surgical practice. ⋯ The article concludes by discussing the importance of information on functional status, survival, neurocognition, quality of life, and cardiac physiology in therapeutic decision making.
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J. Thorac. Cardiovasc. Surg. · Jun 2012
Comparative StudyOn-pump and off-pump coronary artery bypass grafting in patients with left main stem disease: a propensity score analysis.
This study compared safety and efficacy between off-pump coronary artery bypass grafting (OPCAB), a relatively new technique, and conventional on-pump coronary artery bypass grafting (CCAB) in patients with left main stem disease. ⋯ OPCAB in patients with left main stem disease is a safe procedure with reduced early morbidity and mortality and similar long-term survival to conventional on-pump revascularization.