The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2010
Multicenter StudySutureless aortic valve replacement with the Trilogy Aortic Valve System: multicenter experience.
To evaluate the modular sutureless Arbor Trilogy Aortic Valve System (Arbor Surgical Technologies, Irvine, Calif), designed for minimally invasive aortic valve replacement. ⋯ Sutureless aortic valve replacement is feasible and safe with the Trilogy System. After an initial learning curve, the modular valve design allows a more rapid and simple implantation compared with conventional stented tissue valves. The simplicity may also facilitate a greater adoption of minimally invasive aortic valve replacement by a broader spectrum of surgeons.
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J. Thorac. Cardiovasc. Surg. · Oct 2010
Perventricular device closure of perimembranous ventricular septal defects in 61 young children: early and midterm follow-up results.
Perventricular device closure of perimembranous ventricular septal defect as a novel technique has recently been described in several small series with initial experience. Further studies with larger cohorts and longer-term follow-up are needed to confirm the validity of this new approach. This report describes our recent experience with perventricular device closure of perimembranous ventricular septal defects on beating hearts in 61 young children with over 1 year of follow-up. ⋯ Perventricular device closure of ventricular septal defect is a safe and efficacious treatment option with acceptable midterm outcomes. For infants with poor vascular access, it might be the procedure of choice.
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J. Thorac. Cardiovasc. Surg. · Oct 2010
Multicenter Study Comparative StudyRole of age in acute type A aortic dissection outcome: report from the International Registry of Acute Aortic Dissection (IRAD).
The increasing life expectancy of the population will likely be accompanied by a rise in the incidence of acute type A aortic dissection. However, because of an increased risk of cardiac surgery in an elderly population, it is important to define when, if at all, the risks of aortic repair outweigh the risk of death from unoperated type A aortic dissection. ⋯ Although the surgical mortality significantly increased with increased age, surgical management was still associated with significantly lower in-hospital mortality rates compared with medical management until the age of 80 years. Surgery may decrease the in-hospital mortality rate for octogenarians with type A aortic dissection and might be considered in all patients with type A aortic dissection regardless of age.
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J. Thorac. Cardiovasc. Surg. · Oct 2010
Multicenter Study Clinical TrialSix-month results of a repositionable and retrievable pericardial valve for transcatheter aortic valve replacement: the Direct Flow Medical aortic valve.
Transcatheter aortic valve implantation is considered an alternative for patients at high risk for conventional surgery. The Direct Flow Medical aortic valve (Direct Flow Medical, Inc, Santa Rosa, Calif) is a nonmetallic tissue valve prosthesis intended to treat patients with severe aortic stenosis at high risk for surgery. ⋯ Transcatheter aortic valve implantation using the study valve appears safe and results are promising at 6 months. Severe leaflet and left ventricular outflow tract calcification affects procedural outcome; therefore, careful patient selection is crucial.
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J. Thorac. Cardiovasc. Surg. · Oct 2010
Multicenter StudyPulmonary vein isolation and autonomic denervation for the management of paroxysmal atrial fibrillation by a minimally invasive surgical approach.
Advances in technology such as epicardial bipolar radiofrequency pulmonary vein isolation, ganglionated plexi identification, and isolation and thoracoscopic left atrial appendage exclusion have enabled less invasive surgical options for management of atrial fibrillation. ⋯ Minimally invasive surgical ablation is effective in the management of paroxysmal atrial fibrillation as evidenced by freedom from atrial arrythmias by long-term monitoring at 12 months. Measuring success using clinical symptoms underestimated clinical success as compared with long-term monitoring.