Journal of cardiac surgery
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Comparative Study
Assessment of EuroSCORE in patients undergoing aortic valve replacement.
The logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) is a risk stratification system used to predict the operative risk in patients undergoing surgical aortic valve replacement (AVR). The aim of this study is to investigate how accurate this system is, and how it compares to the observed risk. ⋯ The logistic EuroSCORE overestimates the risks for AVR. Therefore, it should not be used to deny high-risk patients a surgical AVR.
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Comparative Study
Strategies and outcomes of cardiac surgery in Jehovah's Witnesses.
Jehovah's Witnesses (JW) are a Christian faith, with an estimated 1.1 million members in the United States, well recognized for their refusal of blood and blood products. JW may not be considered for cardiac surgery due to perceived higher risks of morbidity and mortality. This study reviews our contemporary strategies and experience with JW undergoing routine and complex cardiac surgery. ⋯ Using a multidisciplinary approach to blood management, JW can safely undergo routine and complex cardiac surgery with minimal morbidity and mortality.
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We report our experience with a five-year-old child with d-transposition of great arteries (d-TGA), ventricular septal defect (VSD), and severe pulmonary arterial hypertension (PAH). A fenestrated unidirectional-valved patch was used to close the VSD and a standard arterial witch operation (ASO) was performed. Difficulties in assessment of operability and the choice of procedures in such patients are briefly discussed.
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Diagnosing a paradoxical embolism is challenging, and it can be proven only if the thrombus is identified across the intracardiac defect. Very few cases have been diagnosed as an impending paradoxical embolism. ⋯ We report a patient with an impending paradoxical embolism that was caught in transit across the patent foramen ovale. The patient was treated successfully with emergent surgery.
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Hemathorax is an uncommon but well-described complication of type B acute aortic dissection. Due to the location and anatomic relations of the descending aorta, aortic rupture of acute type B aortic dissection usually causes a left hemathorax. We now report the case of a 42-year-old male who presented with an acute type B aortic dissection and bilateral hemathoraces.