The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Impact of tricuspid regurgitation after redo valvular surgery on survival in patients with previous mitral valve replacement.
The impact on survival of tricuspid regurgitation (TR) after redo valvular surgery in patients with previous mitral valve replacement (MVR) is unclear. ⋯ Survival in patients with TR of 2+ or higher after redo valvular surgery was poor. The results of this study suggest that it is important to maintain a postoperative TR less than 2+ to improve long-term survival.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Analysis of the learning curve for beating heart, totally endoscopic, coronary artery bypass grafting.
Robotic cardiac surgery has been proved safe and feasible in dedicated centers. We systematically analyzed the learning curve issues associated with totally endoscopic coronary artery bypass grafting (TECAB) using a stepwise approach by a single surgeon who had successfully performed >650 cases of various types of robotic cardiac surgery at our single center. ⋯ Modular-based TECAB procedures can be successfully performed; however, each module has a steep learning curve. A stable and well-trained robotic cardiac team and an experienced cardiac surgeon can achieve good, reproducible results after this substantial learning curve.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Hybrid approach for transcatheter paravalvular leak closure of mitral prosthesis in high-risk patients through transapical access.
To report "hybrid" procedure feasibility and the clinical success of transcatheter paravalvular leak closure through apical access. ⋯ A "hybrid approach" for transcatheter paravalvular leak closure of mitral prosthesis from the apical route is effective in reducing the regurgitation grade and improving functional capacity in high-risk patients. Complete closure of the defect was maintained at follow-up in most patients.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Relationship among surgical volume, repair quality, and perioperative outcomes for repair of mitral insufficiency in a mitral valve reference center.
Although it has been demonstrated that the repair rates and quality of the repair of mitral insufficiency are superior in mitral valve reference centers, it has not been studied whether an advantage exists for perioperative morbidity and mortality. We report 1 surgeon's evolution over 7 years, specifically considering the changes in perioperative morbidity and mortality. ⋯ As the number of mitral valve repairs performed each year by a single surgeon at a single institution increased, morbidity, including postoperative heart function and length of stay, decreased. This was demonstrated to occur in large part from a reduction in the aortic crossclamp times, despite an increase in the complexity of the procedures. This further demonstrates the value of reference centers for mitral valve surgery.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative Study Observational StudyLate outcomes comparison of nonelderly patients with stented bioprosthetic and mechanical valves in the aortic position: a propensity-matched analysis.
Our study compares late mortality and valve-related morbidities between nonelderly patients (aged <65 years) undergoing stented bioprosthetic or mechanical valve replacement in the aortic position. ⋯ In patients aged <65 years, despite an increase in the rate of reoperation with stented bioprosthetic valves and an increase in major bleeding events with mechanical valves, there is no significant difference in mortality at late follow-up.