The Annals of thoracic surgery
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Comparative Study
Surgery in adults with congenital heart disease: risk factors for morbidity and mortality.
Patients with congenital heart disease are frequently surviving into adulthood, and many of them will require surgery. Unfortunately, outcome data in this patient population are limited. We aimed to identify risk factors associated with adverse events in adults with congenital heart disease undergoing cardiac surgery and establish long-term survival data. ⋯ Surgery in adults with congenital heart disease can be performed with low morbidity and mortality. Nonetheless, there remain important risk factors for adverse events. Awareness and modification of risk factors may help improve outcomes.
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Case Reports
Hybrid repair of subclavian-axillary artery aneurysms and aortic arch aneurysm in a patient with Marfan syndrome.
A patient with Marfan syndrome who had previously undergone a Cabrol procedure and thoracoabdominal aortic replacement had enlarging, symptomatic aneurysms in the subclavian-axillary artery and aortic arch. Both vessels were replaced with prosthetic grafts. ⋯ All the stent graft landing zones were within grafts, avoiding contact between the endoprostheses and fragile aortic wall. The aneurysms were excluded from the circulation, and the patient had no serious complications.
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Comparative Study
Reversible pulmonary trunk banding VIII: Intermittent overload causes harmless hypertrophy in adult goat.
Traditional pulmonary artery banding (PAB) is not always suitable for mature subpulmonary ventricle retraining. We sought to assess in detail the myocardial morphologic adaptations of two different protocols for inducing right ventricular (RV) hypertrophy in an adult animal model. ⋯ This study suggests that a more effective and harmless hypertrophy can be achieved in adult animals using intermittent PAB compared with the traditional approach.
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Multicenter Study Comparative Study
The Society of Thoracic Surgeons risk model for operative mortality after multiple valve surgery.
This study was undertaken to develop The Society of Thoracic Surgeons (STS) mortality risk models for multiple valve procedures, which comprise 12% of total valve operations. ⋯ Risk models were developed to predict operative mortality for patients having multiple valve procedures. These models may be useful for outcome assessment, quality improvement, patient counseling, shared decision making, and research.
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Comparative Study
A comprehensive review of anastomotic technique in 432 esophagectomies.
Little consensus exists and varying outcomes are reported when the 4 most common esophagogastric anastomotic techniques are compared: circular stapled (CS), hand sewn (HS), linear stapled (LS) (longitudinally stapled anastomosis), and modified Collard (MC) (combined linear and transverse stapled anastomosis). This report analyzes outcomes of these anastomotic techniques. ⋯ When performing an esophagogastric anastomosis, clinically significant leaks occur with similar frequency in both cervical and intrathoracic locations. The HS technique has the highest leak rate and the LS technique had the lowest rate of stricture formation.