The Annals of thoracic surgery
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Case Reports
Valve Sparing Aortic Root Replacement for Aortico-Left Ventricular Tunnel With Bicuspid Aortic Valve.
Aortico-left ventricular tunnel (ALVT) is a rare, abnormal, paravalvular communication between the aorta and the left ventricle. ALVT can be associated with a variety of congenital heart diseases, but there are only a few reports of ALVT associated with bicuspid aortic valve (BAV). Herein, we report a case of an 11-year-old boy who successfully underwent aortic valve sparing root replacement for ALVT with BAV and aortic root aneurysm.
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Practice Guideline
Adult Cardiac Surgery During the COVID-19 Pandemic: A Tiered Patient Triage Guidance Statement.
In the setting of the current novel coronavirus pandemic, this document has been generated to provide guiding statements for the adult cardiac surgeon to consider in a rapidly evolving national landscape. Acknowledging the risk for a potentially prolonged need for cardiac surgery procedure deferral, we have created this proposed template for physicians and interdisciplinary teams to consider in protecting their patients, institution, and their highly specialized cardiac surgery team. In addition, recommendations on the transition from traditional in-person patient assessments and outpatient follow-up are provided. Lastly, we advocate that cardiac surgeons must continue to serve as leaders, experts, and relevant members of our medical community, shifting our role as necessary in this time of need.
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Pragmatic Clinical Trial
Prospective Evaluation of a Blood Transfusion Protocol for Patients Undergoing Cardiac Operations.
The Society of Thoracic Surgeons clinical practice guidelines recommend the creation of an interdisciplinary blood management team to implement protocols for improved blood transfusion practices. We report our center's prospective evaluation of a blood transfusion protocol. ⋯ During a prospective evaluation of blood transfusion protocols, a risk-adjusted analysis demonstrated a reduction in transfusions despite poor protocol compliance.
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Contemporary experiences regarding childhood hypertrophic obstructive cardiomyopathy are limited. This study aimed to describe the clinical presentation of childhood hypertrophic obstructive cardiomyopathy and its relevant surgical outcome. ⋯ In our cohort of children with hypertrophic obstructive cardiomyopathy undergoing septal myectomy, biventricular obstruction, myocardial bridging, and intraventricular anatomic abnormalities are frequent phenotypic components. Despite the complexity of childhood hypertrophic obstructive cardiomyopathy, surgical treatment results in a favorable outcome in carefully selected patients.