The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyComparison of early hemodynamic performance of 3 aortic valve bioprostheses.
The study objective was to determine whether the new-generation Trifecta (St Jude Medical Inc, St Paul, Minn) bovine aortic valve bioprosthesis, which is designed for supra-annular positioning, produces early postoperative hemodynamic results comparable to or better than those of the Mitroflow (Sorin Group, Milan, Italy) or Perimount Magna (Edwards Lifesciences Corp, Irvine, Calif) bovine aortic valve bioprostheses. ⋯ Early hemodynamic postoperative performance of the Trifecta bioprosthesis is favorable. Additional follow-up should determine whether these small hemodynamic differences will persist and influence later clinical outcomes.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyPrevious coronary stents do not increase early and long-term adverse outcomes in patients undergoing off-pump coronary artery bypass grafting: a propensity-matched comparison.
The aim of our study was to compare the early and long-term outcomes of patients undergoing off-pump coronary artery bypass grafting (CABG) with and without previous coronary stents. ⋯ Previous coronary stents do not increase early and long-term morbidity or mortality in patients undergoing off-pump CABG.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Multicenter StudyChronic competitive flow from a patent arterial or venous graft to the circumflex system does not impair the long-term patency of internal thoracic artery to left anterior descending grafts in patients with isolated predivisional left main disease: long-term angiographic results of 2 different revascularization strategies.
To compare 2 different surgical approaches to treatment of patients with isolated predivisional stenosis of the left main coronary artery (IOSLM) and to evaluate the effect of chronic competitive flow from a patent arterial or venous graft to the circumflex system on the long-term patency of internal thoracic artery (ITA) to left anterior descending grafts. ⋯ In patients with IOSLM, long-term ITA to left anterior descending artery patency is not jeopardized by chronic flow competition from a concomitant arterial or venous graft to the circumflex system. Notably, the addition of a second ITA graft or of a SV to the first ITA does not lead to differences in long-term angiographic patency. Our results minimize the role of flow competition in this setting and should be kept in mind when choosing the appropriate graft configuration.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative StudyEarly and midterm outcomes of hemiarch replacement combined with stented elephant trunk in the management of acute DeBakey type I aortic dissection: comparison with total arch replacement.
For patients with acute DeBakey type I aortic dissection without an intimal tear in the arch, the early and midterm outcomes of hemiarch replacement with stented elephant trunk were compared with those of total arch replacement. ⋯ For patients with acute DeBakey type I dissection without an intimal tear in the arch, hemiarch replacement with stented elephant trunk implantation was easily performed, with satisfactory early and midterm outcomes. For these selective patients, total arch replacement with the stented elephant trunk technique did not improve the late surgical results further.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Analysis of Clostridium difficile infections after cardiac surgery: epidemiologic and economic implications from national data.
Clostridium difficile infections (CDIs) have increased during the past 2 decades, especially among cardiac surgical patients, who share many of the comorbidity risk factors for CDI. Our objectives were to use a large national database to identify the regional-, hospital-, patient-, and procedure-level risk factors for CDI; and determine mortality, resource usage, and cost of CDIs in cardiac surgery. ⋯ Our results have shown that CDI is associated with increased morbidity and resource usage. Additional work is needed to better understand the complex interplay among regional-, hospital-, and patient-level factors.