The Annals of thoracic surgery
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The Freedom Solo (FS) bovine pericardial valve (Sorin Group, Milan, Italy) is a stentless bioprosthesis that was introduced in 2004 and approved by the United States Food and Drug Administration in 2014. No long-term follow-up series are available to date. We report the multicenter experience of 4 European institutions that began implanting FS extensively from its introduction, providing the largest series with long-term follow-up. ⋯ The FS valve provided excellent long-term durability and hemodynamic performance in this large, multicenter European experience. Moreover, the FS, given the low rate of SVD, along with a simple implantability, proved to be a reliable bioprosthesis in the aortic position as a valid alternative to stented bioprostheses.
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Observational Study
Does Platelet Reactivity Predict Bleeding in Patients Needing Urgent Coronary Artery Bypass Grafting During Dual Antiplatelet Therapy?
Up to 15% of patients require coronary artery bypass grafting (CABG) during dual antiplatelet therapy. Available evidence suggests an association between platelet reactivity and CABG-related bleeding. However, platelet reactivity cutoffs for bleeding remain elusive. We sought to explore the association between platelet reactivity and bleeding. ⋯ A gradual decrease in red blood cell loss and BARC-4 bleeding occurs with increasing platelet reactivity in patients on antiplatelet therapy undergoing CABG. Our findings support current guidelines to determine time of surgery based on an objective measurement of platelet function (Platelet Inhibition and Bleeding in Patients Undergoing Emergent Cardiac Surgery; clinicaltrials.gov NCT01468597).
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Case Reports
Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve-in-Ring Implantation: A Word of Caution.
Left ventricular outflow tract obstruction is a well-known, albeit rare, adverse event that can occur after mitral valve replacement. With the current increase in transcatheter valve interventions, new and unique adverse events may be expected to occur. We present a case of severe left ventricular outflow tract obstruction that developed after transcatheter mitral valve implantation.
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Case Reports
Impingement of Single-Tilting Disc Mitral Prosthesis During Transcatheter Aortic Valve Replacement.
An 80-year-old woman with a medical history of mitral valve replacement with single-tilting disc prosthesis underwent transcatheter aortic valve replacement (TAVR). The tilting disc was noted to have abnormal motion after re-ballooning of the TAVR valve. ⋯ After removal of the TAVR valve, the tilting disc moved freely. Although TAVR in patients with mitral prostheses is technically feasible, particular caution is necessary, and postdeployment dilation should be avoided.
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Multicenter data regarding the around-the-clock (24/7) presence of an in-house critical care attending physician with outcomes in children undergoing cardiac operations are limited. ⋯ The presence of 24-hour in-ICU attending physician coverage in children undergoing cardiac operations is associated with improved outcomes, including ICU mortality. It is possible that 24-hour in-ICU attending physician coverage may be a surrogate for other factors that may bias the results. Further study is warranted.