The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Outcome after surgery for prosthetic valve endocarditis and the impact of preoperative treatment.
This study examined the outcomes of surgery for active prosthetic valve endocarditis in a recent decade, with special interest in preoperative treatment and predictors for early and late events. ⋯ Cardiac and renal function, need for double valve replacement, and preoperative treatment predicted outcomes. A prolonged interval in which patients were left untreated while symptomatic, but not prolongation of preoperative antibiotic treatment, increased risk.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Comparative Study Observational StudySurgical repair of descending thoracic and thoracoabdominal aortic aneurysm involving the distal arch: open proximal anastomosis under deep hypothermia versus arch clamping technique.
Surgical repair of a descending thoracic and thoracoabdominal aortic aneurysm (DTA/TAAA) involving the distal arch is challenging and requires either deep hypothermic circulatory arrest (DHCA) or crossclamping of the distal arch. The aim of this study was to compare these 2 techniques in the treatment of DTA/TAAA involving the distal arch. ⋯ Compared with AC, DHCA did not increase postoperative mortality and morbidity, except for prolonged ventilator support. However, DHCA may offer superior spinal cord protection to AC during repair of DTA/TAAA involving the distal arch.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Left atrial endocardial dysfunction and platelet activation in patients with atrial fibrillation and mitral stenosis.
This study demonstrated left atrial endocardial dysfunction and platelet activation in patients with atrial fibrillation and mitral stenosis. ⋯ No differences were observed in plasma levels of vWF and P-selectin between left atrial and peripheral venous blood. Over expression of vWF gene in LAA may contribute to increased plasma vWF levels. P-selectin and vWF together may play a role in thrombosis.
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J. Thorac. Cardiovasc. Surg. · Nov 2014
Long-term outcomes of survival and freedom from reoperation on the aortic root or valve after surgery for acute ascending aorta dissection.
Limited long-term outcome data are available on survival and the need for aortic root or valve reoperation after surgery for acute ascending aorta dissection. We report our 42-year experience. ⋯ Operative morbidity and mortality rates are significant after repair of acute ascending aorta dissection. Aortic root surgery can be performed without an apparent increase in the prevalence of operative morbidity or mortality; however, patients remain at risk of subsequent aortic root or valve surgery.