The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Sep 2013
Factors predictive of distal stent graft-induced new entry after hybrid arch elephant trunk repair with stainless steel-based device in aortic dissection.
Stent graft-induced new entry (SINE) has been increasingly observed after thoracic endovascular aortic repair of aortic dissection. We illustrate the possible mechanism by exploring predictive factors of late distal SINE after hybrid arch elephant trunk repair for aortic dissection. ⋯ We found that taper ratio is not an optimal criteria for stent graft size selection and distal oversizing calculated by true-lumen area is a significant factor causing delayed distal SINE. Use of the prestenting area oversizing ratio should be limited.
-
J. Thorac. Cardiovasc. Surg. · Sep 2013
Recurrence of mitral regurgitation after partial versus complete mitral valve ring annuloplasty for functional mitral regurgitation.
Both partial and complete annuloplasty rings are used for mitral valve repair for patients with functional mitral regurgitation (FMR). We sought to determine if recurrence of mitral regurgitation (MR) is affected by the type of ring used. ⋯ The use of complete mitral annuloplasty rings provides improved freedom from recurrent MR in patients with FMR.
-
J. Thorac. Cardiovasc. Surg. · Sep 2013
Comparative StudyVideo-assisted thoracic surgery for pulmonary sequestration compared with posterolateral thoracotomy.
Pulmonary sequestration is a rare congenital malformation of the lungs. This study aims to evaluate the effectiveness of video-assisted thoracic surgery for the treatment of pulmonary sequestration in a larger series compared with posterolateral thoracotomy. ⋯ Video-assisted thoracic surgery resection for pulmonary sequestration is feasible, although it should be performed by an experienced surgeon with awareness of the potential risk of severe vascular injury.
-
J. Thorac. Cardiovasc. Surg. · Sep 2013
Long-term outcomes of patients with diabetes receiving bilateral internal thoracic artery grafts.
Bilateral internal thoracic artery (BITA) grafting in patients with diabetes are controversial because of increased risk of sternal infection. On the other hand, patients with diabetes may benefit from BITA grafts because of the associated improved survival. This study evaluated factors affecting early and long-term outcomes for better selection of patients with diabetes for BITA grafts. ⋯ BITA grafts are safe in patients with diabetes. Favorable short- and long-term outcomes outweigh increased sternal infection risk.
-
J. Thorac. Cardiovasc. Surg. · Sep 2013
Control of ventricular unloading using an electrocardiogram-synchronized Thoratec paracorporeal ventricular assist device.
Current pulsatile ventricular assist devices operate asynchronous with the left ventricle in fixed-rate or fill-to-empty modes because electrocardiogram-triggered modes have been abandoned. We hypothesize that varying the ejection delay in the synchronized mode yields more precise control of hemodynamics and left ventricular loading. This allows for a refined management that may be clinically beneficial. ⋯ The timing of pump ejection in synchronized mode yields control over left ventricular energetics and can be a method to achieve gradual reloading of a recoverable left ventricle. The traditionally suggested counterpulsation is not optimal in ventriculo-aortic cannulation when maximum unloading is desired.