The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Preoperative transcatheter occlusion of bronchopulmonary collateral artery reduces reperfusion pulmonary edema and improves early hemodynamic function after pulmonary thromboendarterectomy.
The present study assessed the effectiveness of preoperative transcatheter occlusion of the bronchopulmonary collateral artery (PTOBPCA) in reducing reperfusion pulmonary edema after pulmonary thromboendarterectomy (PEA). ⋯ PTOBPCA can reduce the incidence of reperfusion pulmonary edema, shorten intensive care unit hospitalization and intubation duration, improve early hemodynamic function, and reduce ECMO usage after PEA.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Survival after intervention in patients with low gradient severe aortic stenosis and preserved left ventricular function.
The outcome of aortic valve replacement for patients with low gradient severe aortic stenosis and preserved ejection fraction has been debated. The aim of the present study was to evaluate the effect of aortic valve intervention on survival in that group. ⋯ Our findings suggest that aortic valve intervention is associated with improved survival among patients with low gradient severe aortic stenosis and preserved left ventricular function. The presence of either a low or normal stroke volume index did not affect the mortality benefit.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative Study Observational StudyProfound hypothermia compared with moderate hypothermia in repair of acute type A aortic dissection.
To determine the impact of the degree of hypothermia on surgical outcomes in patients undergoing repair of acute type A aortic dissection. ⋯ MH was independently associated with a lower risk of a composite outcome of mortality and major adverse cardiac and cerebrovascular events during repair of acute type A dissection. Use of moderate hypothermic circulatory arrest avoids the detrimental effects of PH without an increase in the risk of neurologic injury in this study.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Constrictive pericarditis requiring pericardiectomy at Groote Schuur Hospital, Cape Town, South Africa: causes and perioperative outcomes in the HIV era (1990-2012).
The causes of constrictive pericarditis and predictors of perioperative outcome after pericardiectomy have not been clearly elucidated, especially in Africa, where the disease characteristics differ from those in developed countries. Furthermore, the effect of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) on pericardial constriction and outcomes after surgery is unknown. We investigated the causes of constrictive pericarditis, outcomes after pericardiectomy, and predictors of mortality in Cape Town, South Africa, during a 22-year period of high HIV/AIDS prevalence. ⋯ Tuberculosis is the main cause of constrictive pericarditis in South Africa. Despite its efficacy at relieving the symptoms of heart failure, pericardiectomy is associated with high perioperative mortality that was not influenced by HIV status. New York Heart Association functional class IV and hyponatremia predict for early mortality after pericardiectomy.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Reoperations on the total aortic arch in 119 patients: short- and mid-term outcomes, focusing on composite adverse outcomes and survival analysis.
To determine the preoperative and perioperative risk factors that significantly predict adverse outcomes after total arch replacement in patients with previous proximal aortic surgery and to analyze patient survival. ⋯ Aortic arch reoperations, although technically demanding, can produce acceptable results. Preoperative pulmonary disease, CPB time, and concomitant coronary artery bypass predicted an adverse outcome. The CPB time predicted mortality, and previous thoracoabdominal aortic surgery predicted stroke.