The Annals of thoracic surgery
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Comparative Study
Aortic valve reconstruction of unicuspid aortic valve by tricuspidization using autologous pericardium.
Unicuspid aortic valve is a rare anatomic variant, but patients may require intervention for severe valve dysfunction at a young age. We introduce a new reconstructive technique for diseased unicuspid valve by tricuspidization with glutaraldehyde-treated autologous pericardium. ⋯ Diseased unicuspid aortic valves were treated by our original aortic valve reconstruction technique with excellent early results. We continue to study the long-term results.
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Multicenter Study Comparative Study
Who performs complex noncardiac thoracic surgery in United States academic medical centers?
We hypothesized that general thoracic surgeons (GTS) predominantly perform complex noncardiac thoracic surgery in academic hospitals compared with cardiac surgeons (CS), general surgeons, and surgical oncologists. ⋯ In academic hospitals, noncardiac thoracic surgery is performed mostly by GTS, supporting academic GTS as a distinct specialty. These results may help determine hospital referral and credentialing policies, and plan general and cardiothoracic surgery residency curriculum.
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We conducted a retrospective study of cyanotic and acyanotic patients undergoing cardiopulmonary bypass to determine the effect of tranexamic acid on blood loss and blood products administered during the operation in pediatric cardiac surgery. ⋯ This retrospective study provides evidence that tranexamic acid may be used in the field of congenital cardiac surgery effectively.
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Comparative Study
Fontan conversion to one and one half ventricle repair.
In patients with a modified Fontan connection, particularly the right atrial to right ventricular connection, the pulmonary ventricle may enlarge with time. ⋯ Fontan conversion to one and one half ventricle repair is feasible in selected patients with a failing Fontan circulation. Operation can be performed with low early mortality. Arrhythmia surgery should be performed routinely. Quality of life is excellent.
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Comparative Study
Technical performance scores in congenital cardiac operations: a quality assessment initiative.
Technical performance in congenital cardiac operations and its association with clinical outcomes was previously examined in infants and neonates. The purpose of this study was the development and implementation of a system for measuring technical performance in the majority of congenital cardiac operations to be used as a surgeon's self-assessment tool. ⋯ The development and implementation of a broad technical performance self-assessment system for congenital cardiac operations is possible. Based on this scoring system, the impact of a less than optimal (2 or 3) technical score depends on case risk category, with higher mortality in the higher risk group, and increased resource use for lower risk procedures.