The Annals of thoracic surgery
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Randomized Controlled Trial Comparative Study
Deep Hypothermia With Retrograde Cerebral Perfusion Versus Moderate Hypothermia With Antegrade Cerebral Perfusion for Arch Surgery.
Patients undergoing aortic arch replacement are at high risk for neurologic injury. This study compared two different established neuroprotective strategies in patients undergoing elective transverse hemiarch replacement. ⋯ Although there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
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Multicenter Study
Third Annual Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) Report: Preimplant Characteristics and Outcomes.
The influence of ventricular assist device (VAD) use in the care of children with end-stage heart failure is growing rapidly through increasing numbers, new devices, expanding indications, and improving outcomes. Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), a National Institutes of Health-sponsored United States database, provides a platform to understand this emerging population. ⋯ IC VADs are the most common VAD type placed in children. The positive outcomes for the IC VADs exceed 90% at 6 months, which may represent our field's maturation in both patient selection and timing of implantation. The PP/PC devices are currently limited to supporting our most challenging patients, those weighing less than 20 kg and those with CHD. The introduction of new devices and our communities' commitment to shared learning and improvement will lead to more pediatric lives saved by VAD support and will also focus on improving the quality of life of children supported with VADs.
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Comparative Study
Comparison Between Esophagectomy and Definitive Chemoradiotherapy in Patients With Esophageal Cancer.
This study compared survival between definitive chemoradiotherapy (CRT) and esophagectomy alone among patients with locoregional esophageal squamous cell carcinoma (SCC). ⋯ Esophagectomy alone could provide better survival than definitive CRT for patients with clinical stage I/II esophageal SCC. However, definitive CRT and esophagectomy yield similar overall survival rates in clinical stage III patients.
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Over the last decade, aortic valve replacement with rapid-deployment biologic bioprostheses has become a common alternative to the use of mechanical or biologic stented valves for high-risk patients. A 63-year-old patient underwent uncomplicated valve replacement with the Edwards Intuity valve (Edwards Lifesciences, Irvine, CA). ⋯ Both valves were replaced by a conventional stented bioprosthesis. This case report describes the first case of valve migration for the Edwards Intuity Elite rapid-deployment aortic valve and discusses possible explanations.