The Annals of thoracic surgery
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A patient with double inlet left ventricle with transposition of great arteries and severe coarctation of the aorta received aortoplasty and pulmonary artery banding, followed by bidirectional Glenn shunt and extracardiac total cavopulmonary connection (TCPC). Severe subaortic stenosis and increased atrioventricular valve regurgitation were noted 4 years after TCPC. ⋯ The TCPC was taken down with both caval veins reconnected to the right atrium; the neopulmonary artery was reconstructed. Biventricular conversion from TCPC was achieved.
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Transapical, beating heart, off-pump implantation of neochordae for repair of mitral valve (MV) prolapse is of increasing interest. The aim of this study was to evaluate long term results for MV repair using the NeoChord system (NeoChord, St. Louis Park, MN). ⋯ In select patients, MV repair using the NeoChord system results in very good long-term results without recurrent prolapse, MR, or annular dilatation.
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Comparative Study
Transplant Outcomes for Congenital Heart Disease Patients Bridged With a Ventricular Assist Device.
Ventricular assist device (VAD) use as a bridge to transplant (BTT) for children with end-stage heart failure and congenital heart disease (CHD), although challenging, has increased, but its effect on posttransplant outcome is unknown. This study describes posttransplant outcomes of CHD patients BTT with a VAD. ⋯ Although more ill pretransplant, CHD patients BTT with a VAD have similar posttransplant survival compared with CHD patients without a VAD and with other non-CHD heart transplant patients. VAD support may mitigate certain risk factors for poor posttransplant outcomes in the challenging CHD cohort.
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Comparative Study
Coronary Revascularization With Single Versus Bilateral Mammary Arteries: Is It Time to Change?
Arterial conduits are preferred to venous conduits for coronary artery bypass grafting because of longer patency. A single internal mammary artery (SIMA) is used routinely. Bilateral internal mammary arteries (BIMA) are used less frequently. We sought to determine whether BIMA were superior to SIMA. ⋯ In a large regional experience, BIMA is associated with no upfront risk of adverse events and improved long-term survival compared with SIMA. Our results indicate that BIMA conduits should be considered more frequently during coronary artery bypass grafting due to their demonstrated survival advantage.