Journal of cardiac surgery
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The goal of this article is to provide an outline of the latest advances in critical care that pertain to the open heart surgery patient, pinpointing initiatives that would enable physicians and institutions to successfully implement guidelines, protocols, checklists, and initiatives that have been shown to improve patient safety.
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Recent studies have found increased long-term cardiovascular morbidity after off-pump coronary artery bypass surgery (OPCAB). We evaluated the efficacy and safety of dual antiplatelet therapy (DAT) in the prevention of cardiovascular events at two years after OPCAB surgery. ⋯ Dual antiplatelet therapy after OPCAB surgery is associated with a decrease in the appearance of new cardiovascular events, due to a reduction in the number of hospital readmissions for ACS.
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Case Reports
Intraoperative transeophageal echocardiography to diagnose an anomalous circumflex artery.
We describe a 43-year-old male presenting for hemiarch replacement and possible aortic valve replacement. Intraoperative transesophageal echocardiography (TEE) demonstrated an atypical coronary vessel, enabling proper diagnosis of an anomalous circumflex artery and appropriate operative planning.
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Even mild paravalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) is associated with increased late mortality. Electrocardiogram-gated multi-slice computed tomography (MSCT) enables detailed aortic annulus assessment. We describe the impact of MSCT for PVL following TAVR. ⋯ The OSACA ratio has a significantly higher discriminatory performance for PVL ≤ trace than the OSACA (TEE) ratio, and aortic annular measurement from MSCT is more accurate than that from TEE.
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Case Reports
Successful single-stage repair of an interrupted aortic arch with a bicuspid aortic valve in a young adult.
Interrupted aortic arch is a rare congenital malformation. We describe the case of an interrupted aortic arch with a bicuspid aortic valve and severe aortic stenosis. The patient underwent a single-stage aortic valve replacement (AVR) and ventral aorta repair through a median sternotomy-laparotomy.