The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyEffect of aortic aneurysm replacement on outcomes after bicuspid aortic valve surgery: validation of contemporary guidelines.
Bicuspid aortic valve (BAV) disease is associated with aortic dilatation and aneurysm (AN) formation. The American College of Cardiology/American Heart Association (ACC/AHA) 2006 guidelines recommend replacement of the ascending aorta for an aortic diameter (AD)> 45 mm in patients undergoing aortic valve replacement (AVR). We evaluated the outcomes of AVR and AVR with aortic replacement (AVR/AN). ⋯ In patients with undergoing AVR, no increase was seen in morbidity or mortality when adding aortic replacement with an AD of 45 to 49 mm, in accordance with the 2006 ACC/AHA guidelines, although the AVR/AN AD≥50-mm group had a greater risk of respiratory complications. Our findings indicate that compliance with the ACC/AHA guidelines is safe in select centers.
-
J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyEvent recorder monitoring to compare the efficacy of a left versus biatrial lesion set in patients undergoing concomitant surgical ablation for atrial fibrillation.
Various lesion sets and subsequent success rates have been reported in patients receiving concomitant surgical ablation for atrial fibrillation. However, most of these results have been obtained by discontinuous monitoring. We report results using continuous event recorder rhythm monitoring to compare more accurately the efficacy of a left versus biatrial lesion set to treat patients with persistent atrial fibrillation. ⋯ Continuous rhythm monitoring by subcutaneous event recorder implantation was safe and feasible. In patients undergoing biatrial ablation, a statistically significant higher rate of freedom from atrial fibrillation was observed at 12 months follow-up.
-
J. Thorac. Cardiovasc. Surg. · Nov 2014
Multicenter StudyContinuative statin therapy after percutaneous coronary intervention improves outcome in coronary bypass surgery: a propensity score analysis of 2501 patients.
A history of percutaneous coronary intervention increases the risk of death and complications of coronary artery bypass grafting. This retrospective multicenter study evaluated the impact of continuative use of statin on postoperative outcomes when subsequent elective coronary artery bypass grafting is required after percutaneous coronary intervention. ⋯ Long-term statin treatment after percutaneous coronary intervention improves early and midterm outcome when surgical revascularization will be required.
-
J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyMetabolic characteristics of human hearts preserved for 12 hours by static storage, antegrade perfusion, or retrograde coronary sinus perfusion.
Machine perfusion of donor hearts is a promising strategy to increase the donor pool. Antegrade perfusion is effective but can lead to aortic valve incompetence and nonnutrient flow. Experience with retrograde coronary sinus perfusion of donor hearts has been limited. We tested the hypothesis that retrograde perfusion could support myocardial metabolism over an extended donor ischemic interval. ⋯ Machine perfusion by either the antegrade or the retrograde technique can support myocardial metabolism over long intervals. Machine perfusion seems promising for long-term preservation of human donor hearts.
-
J. Thorac. Cardiovasc. Surg. · Nov 2014
Observational StudySingle center experience with the Sorin Bicarbon prosthesis: a 17-year clinical follow-up.
To evaluate the long-term results of aortic valve replacement (AVR) and mitral valve replacement (MVR) with the Sorin Bicarbon prosthesis (SBP). ⋯ The SBP has shown excellent results in terms of clinical improvement and freedom from valve-related complications, even up to 17 years after AVR and MVR. It therefore seems to be a safe option whenever a mechanical prosthesis is needed.