European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jun 2019
Observational StudySilent cerebral infarction after thoracic endovascular aortic repair: a magnetic resonance imaging study.
Silent cerebral infarction is the most common brain injury incidentally detected on imaging and can be associated with increased risks of future stroke and cognitive decline. However, the incidence and risk factors of silent cerebral infarction after thoracic endovascular aortic repair (TEVAR) for aortic arch pathologies remain unclear. This study aimed to examine silent cerebral infarction following TEVAR using diffusion-weighted (DW) magnetic resonance imaging (MRI). ⋯ The incidence of silent cerebral infarction following TEVAR with supra-aortic debranching for aortic arch pathologies was 21%, and the severity of atheromatous change in the aortic arch, especially in the proximal landing zone, was positively associated with the development of silent cerebral infarction.
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Eur J Cardiothorac Surg · Jun 2019
Multicenter Study Comparative Study Observational StudyBiological or mechanical prostheses for isolated aortic valve replacement in patients aged 50-65 years: the ANDALVALVE study.
The decision about whether to use a biological or a mechanical prosthesis for aortic valve replacement remains controversial in patients between 50 and 65 years of age and has yet to be addressed in a Mediterranean population. This research aimed to analyse long-term survival and major morbidity rates (30-day mortality, stroke, any prosthetic reoperation and major bleeding) within this population. ⋯ NCT03239509.
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Eur J Cardiothorac Surg · Jun 2019
Multicenter StudyHiatal hernia after oesophagectomy: a large European survey.
Hiatal hernias (HH) after oesophagectomy are rare, and their surgical management is not well standardized. Our goal was to report on the management of HH after oesophagectomy in high-volume tertiary European French-speaking centres. ⋯ Surgical management of HH after oesophagectomy could be done by laparoscopy in patients with scheduled surgery but laparotomy or thoracotomy was preferred in urgent situations. The incidence of HH after oesophagectomy is higher and its onset earlier when laparoscopy is used at the initial oesophagectomy.
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Eur J Cardiothorac Surg · Jun 2019
Locational impact of luminal communication on aortic diameter changes and reintervention in acute type I aortic dissection.
The aim of this study is to evaluate the locational impact of a luminal communication on aortic diameter changes and reintervention after surgical repair of acute type I aortic dissection. ⋯ A luminal communication at the proximal descending thoracic aorta (segment 1) is a significant factor for an increasing aortic diameter and reintervention after surgical repair of acute type I aortic dissection.
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Eur J Cardiothorac Surg · Jun 2019
Observational StudyAcquired von Willebrand syndrome in paediatric patients during mechanical circulatory support.
Bleeding signs can become life-threatening complications in patients on mechanical circulatory support (MCS). Clinical phenotyping and comprehensive analyses of the cause of bleeding are, therefore, essential, especially when risk-stratifying patients during MCS workup. We conducted coagulation analyses and determined von Willebrand factor (VWF) parameters in a paediatric cohort on temporary extracorporeal life support, extracorporeal membrane oxygenation or long-term ventricular assist device support. ⋯ The AVWS prevalence in paediatric patients on MCS is 100% regardless of the types of devices tested in this study. The bleeding propensity of AVWS patients widely varies.