The Annals of thoracic surgery
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Even if the thoracic endovascular aortic repair or open stent grafting technique becomes popular, surgical total arch replacement is still important and will continue to be necessary. Distal anastomosis of total arch replacement is critical in this procedure. This article describes an easy and useful method for using a malleable retractor ring in the distal anastomosis of the total arch replacement.
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Randomized Controlled Trial Multicenter Study Comparative Study
Coronary artery bypass graft patency: residents versus attending surgeons.
Data are limited regarding the patency of coronary artery bypass grafts performed by residents versus attending surgeons. ⋯ Surgeons in training perform coronary artery bypass surgery without compromising graft patency or patient outcomes. Ongoing evaluation of residents' performance and surgical outcomes is needed, given the major changes that are occurring in residency training.
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Multicenter Study
Variation in outcomes for risk-stratified pediatric cardiac surgical operations: an analysis of the STS Congenital Heart Surgery Database.
We evaluated outcomes for groups of risk-stratified operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database to provide contemporary benchmarks and examine variation between centers. ⋯ This analysis documents contemporary benchmarks for risk-stratified pediatric cardiac surgical operations grouped by STAT Mortality Categories and the range of outcomes among centers. Variation was greatest for the more complex operations. These data may aid in the design and planning of quality assessment and quality improvement initiatives.
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Outcomes after atrioventricular (AV) valve operations in patients with functional single ventricles are unclear. ⋯ AV valve regurgitation is a considerable burden for the patient with a single ventricle, especially when appearing at a young age. A quarter of patients died within the first year after operation, and they had considerable morbidity in terms of reoperation, thromboembolic events, and pacemaker implantation. Their chances of reaching Fontan completion seemed decreased.
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Case Reports
Hybrid endovascular treatment of an anomalous right subclavian artery dissection in a patient with Marfan syndrome.
We report the case of a 26-year-old female patient with Marfan syndrome and an aberrant right subclavian artery (ARSA) with associated Kommerell diverticulum. The patient presented with spontaneous acute dissection of the ARSA that showed fusiform dilation to 4 cm in diameter. Definitive treatment was performed using a two-stage hybrid endovascular technique, including extrathoracic bilateral upper extremity bypass and thoracic endovascular aortic repair with debranching of the right and left subclavian arteries. This was followed by coil and plug embolization to exclude the dissection and prevent subsequent endoleak.