The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2013
Understanding right ventricular dysfunction and functional tricuspid regurgitation accompanying mitral valve disease.
The study objective was to correlate the degree of tricuspid regurgitation with clinical indicators of right-sided heart failure and both qualitative and quantitative measures of right-sided heart morphology and function in patients with degenerative mitral valve disease. ⋯ Functional tricuspid regurgitation accompanying mitral valve disease is associated with proportional changes in right-sided heart morphology; however, severe tricuspid regurgitation is nearly always associated with right ventricular dysfunction, suggesting a synergistic relationship. Right ventricular dysfunction is likely as important as tricuspid regurgitation because it offers an explanation for the negative prognostic impact of tricuspid regurgitation and has implications for the clinical management of patients.
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J. Thorac. Cardiovasc. Surg. · May 2013
Risk factors for 1-year mortality after thoracic endovascular aortic repair.
Thoracic endovascular aortic repair, although physiologically well tolerated, may fail to confer significant survival benefit in some high-risk patients. In an effort to identify patients most likely to benefit from intervention, the present study sought to determine the risk factors for 1-year mortality after thoracic endovascular aortic repair. ⋯ Age older than 75 years, aortic diameter greater than 6.5 cm, and American Society of Anesthesiologists class 4 are independently associated with 1-year mortality after thoracic endovascular aortic repair. These clinical characteristics may help risk-stratify patients undergoing thoracic endovascular aortic repair and identify those unlikely to derive a long-term survival benefit from the procedure.
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J. Thorac. Cardiovasc. Surg. · May 2013
Comparative StudyOutcomes after thymectomy in class I myasthenia gravis.
The role of extended thymectomy in the treatment of class I myasthenia gravis is still controversial. This study compared the long-term outcomes of operated and nonoperated patients allocated according to their will. ⋯ Extended thymectomy achieved a more rapid remission than after nonsurgical treatment of class I myasthenia gravis. Significantly better outcomes resulted when thymectomy was performed within 6 months from the onset of symptoms.
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J. Thorac. Cardiovasc. Surg. · May 2013
Depression before and after cardiac surgery: do all patients respond the same?
To characterize the prevalence, incidence, and risk factors for depression before and after cardiac surgery. ⋯ Depression is prevalent in one-third of cardiac surgery patients at time of discharge. It is not associated with operative or postoperative risk factors, with the exception of prolonged hospital stay >7 days. Preoperative depression or being at risk for depression, is associated with the highest risk for postoperative depression.