The Annals of thoracic surgery
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Minimally invasive aortic valve replacement through a right mini-thoracotomy is a procedure developed in the past few years. Currently, the main limits of this technique are longer cardiopulmonary bypass time compared with the standard approach and the need for peripheral cannulation. ⋯ Our initial series confirms that aortic valve replacement performed through a right mini-thoracotomy is a safe procedure. When using running sutures, it is possible to obtain cardiopulmonary bypass and cross-clamping times comparable to those for the standard approach. A central cannulation can be performed easily to avoid groin incisions. In conclusion, we believe that this kind of surgery could really be a biologically minimally invasive approach, rather than just an aesthetic choice.
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Comparative Study
High-risk patients with inoperative aortic stenosis: use of transapical, transaortic, and transcarotid techniques.
Patient characteristics and procedural outcomes from nontransfemoral (non-TF) transcatheter aortic valve replacement (TAVR) in high-risk or inoperable patients with aortic stenosis have been incompletely reported. The purpose of this study was to compare outcomes with non-TF TAVR access techniques including transapical (TA), transaortic (TAo), and transcarotid (TC) TAVR with a balloon-expandable valve. ⋯ In high-risk and inoperable patients who are not candidates for TF TAVR, careful selection of alternative access options can lead to excellent and comparable postoperative outcomes.
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Biography Historical Article
Donald Nixon Ross, BS, MB, ChB, FRCS: pioneering surgeon and true gentleman.
Donald Nixon Ross, FRCS, was a master surgeon, a consummate scholar, and fine gentleman. Herein, are descriptions of his education, practice of cardiac surgery, and legacy contributions. He always will be known for developing and applying the aortic autograft "switch" procedure for aortic stenosis known in perpetuity as the Ross procedure.
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The David V valve-sparing aortic root replacement (David V) has been shown to provide excellent long-term valve function and low rates of valve-related complications in the elective treatment of aortic root aneurysms. The safety and durability of the David V in the repair of acute type A aortic dissection (type A) are currently unclear. In this study, the midterm results of David V in the setting of type A aortic dissection were analyzed. ⋯ The David V can be performed with low morbidity and mortality in young patients presenting with type A aortic dissection who require aortic root replacement. At midterm follow-up, valve function is durable, and the incidence of valve-related complications is low.
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Multicenter Study Comparative Study
Measuring hospital performance in congenital heart surgery: administrative versus clinical registry data.
In congenital heart surgery, hospital performance has historically been assessed using widely available administrative data sets. Recent studies have demonstrated inaccuracies in case ascertainment (coding and inclusion of eligible cases) in administrative versus clinical registry data; however, it is unclear whether this impacts assessment of performance on a hospital level. ⋯ Inaccuracies in case ascertainment in administrative versus clinical registry data can lead to important differences in assessment of hospital mortality rates for congenital heart surgery.