The Annals of thoracic surgery
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Comment Letter Case Reports
Early Blalock-Taussig shunt thrombosis in a neonate with protein C deficiency.
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Comparative Study Clinical Trial Controlled Clinical Trial
Usefulness of preoperative intraaortic balloon pump therapy during off-pump coronary artery bypass grafting in high-risk patients.
In off-pump coronary artery bypass grafting (OPCABG) surgery, the most critical complication is hemodynamic deterioration, which can occur during displacement of the heart to expose the target vessels. Preoperative intraaortic balloon pump (IABP) therapy improves cardiac performance and facilitates access to the target coronary artery while maintaining hemodynamic stability, especially in high-risk patients. ⋯ Preoperative IABP therapy for high-risk coronary patients is very effective in preventing hemodynamic instability and providing surgical results comparable with those in moderate- to lower-risk patients.
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Recently, bicuspid aortic valve disease is posed to be a possible risk factor for dilatation of the pulmonary autograft. ⋯ An autograft procedure in patients with a bicuspid aortic valve is justified. Bicuspid aortic valve disease is not a contraindication for an autograft procedure. Patients with a bicuspid aortic valve will meet the limitations of the autograft procedure in the same frequency as the overall autograft population.
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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.
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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.