The Annals of thoracic surgery
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Comparative Study
Fate of functional mitral regurgitation and predictors of persistent mitral regurgitation after isolated aortic valve replacement.
There are no clear guidelines in regard to optimal management of functional mitral regurgitation (MR) in patients undergoing aortic valve replacement (AVR). This study evaluated changes in functional MR and determined predictors of persistent MR after isolated AVR. ⋯ Functional MR improved in most patients after AVR alone. Postoperative persistent MR affects long-term survival in functional MR. Preoperative RV systolic pressure is an independent risk factor predicting persistent MR.
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Comparative Study
Staged approach prevents spinal cord injury in hybrid surgical-endovascular thoracoabdominal aortic aneurysm repair: an experimental model.
In a porcine model, we investigated the impact of sudden stent graft occlusion of thoracic intercostal arteries after open lumbar segmental artery (SA) ligation. ⋯ These results underline the potential of the staged approach in hybrid procedures. Furthermore they highlight the need for established adjuncts for preventing paraplegia in hybrid and pure stent-graft protocols in which sudden occlusion of multiple SAs occurs.
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Comparative Study
Reoperation and mechanical circulatory support after repair of anomalous origin of the left coronary artery from the pulmonary artery: a twenty-year experience.
Although outcomes for repair of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) have improved, early postoperative mechanical circulatory support is occasionally still required. This study was undertaken to determine whether long-term outcomes for children supported with extracorporeal membrane oxygenation (ECMO) after ALCAPA repair differ from those in children who did not require ECMO. ⋯ Overall survival is excellent after ALCAPA repair. However, those patients who require mechanical support after repair appear to be at higher risk for transplantation or reoperation, typically for mitral regurgitation.
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We report the case of a 22-year-old woman suffering from mature mediastinal teratoma, revealed by trichoptysis, which is an exceptional, but pathognomonic symptom of intrathoracic teratomas. Only eight cases of trichoptysis are reported, none of them involved a mediastinal localization. We present the endoscopic and radiologic presentation, its surgical management, and histologic particularities.
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The international experience with resection of advanced thoracic malignancies performed with extracorporeal membrane oxygenation (ECMO) support is limited. We examined our results to assess the risks and benefits of this approach. ⋯ Based on this experience, we consider VA ECMO support to be a safe alternative to cardiopulmonary bypass (CPB) for advanced general thoracic operations.