The Annals of thoracic surgery
-
Multicenter Study Clinical Trial
Minimally invasive mitral valve repair using the da Vinci robotic system.
Minimally invasive mitral valve repair with a shortened hospital stay and quick return to an active lifestyle is the ultimate goal for robotically assisted surgery. We evaluated our da Vinci robotically assisted mitral valve repair experience toward achieving this goal. ⋯ Mitral valve repair can be successfully performed with the da Vinci robotic system. Long-term follow-up is needed to determine the durability of the repair compared with a standard sternotomy approach.
-
Multicenter Study
Multivariable prediction of in-hospital mortality associated with aortic and mitral valve surgery in Northern New England.
Predicting risk for aortic and mitral valve surgery is important both for informed consent of patients and objective review of surgical outcomes. Development of reliable prediction rules requires large data sets with appropriate risk factors that are available before surgery. ⋯ We present results and methods for use in day-to-day practice to calculate patient-specific in-hospital mortality after aortic and mitral valve surgery, by the logistic equation for each model or a simple scoring system with a look-up table for mortality rate.
-
Diaphragmatic hernias in heart transplant recipients with prior left ventricular assist device (LVAD) placement are a potentially life-threatening complication. This review examined the incidence, diagnostic strategies, surgical management, and prevention of diaphragmatic hernias in these patients. ⋯ Diaphragmatic hernia following VAD placement and heart transplantation requires an aggressive diagnostic and therapeutic approach in this immunosuppressed patient population. We recommend primary closure of all diaphragmatic defects at the time of OHT and VAD explantation to reduce the incidence of this complication.
-
The aim of this study was to clarify preoperative lung function as a prognostic factor for the long-term survival of, and to discuss the appropriateness of lobectomy for, patients with stage I non-small cell lung carcinoma who have poor preoperative pulmonary function. ⋯ Along with tumor size, FEV(1)% is the most significant prognostic factor for patients with stage I non-small cell lung carcinoma with regard to survival from death by other causes. Lobectomy may not be preferred as an appropriate surgical modality for patients with stage I non-small cell lung carcinoma with small peripheral nodules who exhibit poor pulmonary function, especially lowered FEV(1)%.
-
Early and midterm clinical and echocardiographic results after mitral valve (MV) surgery for chronic ischemic mitral regurgitation were investigated to evaluate the validity of the criteria for repair or replacement applied by us. ⋯ Correction of chronic ischemic mitral regurgitation through either repair or replacement provides a good 5-year survival rate, with more than 75% of the survivors in New York Heart Association classes I and II.