The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Off-pump transapical implantation of artificial chordae to correct mitral regurgitation: early results of a single-center experience.
This study evaluated the safety and efficiency of the NeoChord DS1000 system (NeoChord, Inc, Minneapolis, Minn), a device designed to deliver artificial chordae tendineae (neochords) in a beating heart with minimally invasive techniques through left anterolateral minithoracotomy. ⋯ Beating-heart transapical neochord implantation was feasible, could be performed safely, and resulted in a relatively short procedure time. Larger studies and longer follow-up are needed to validate these promising results.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Left thoracoscopic sympathectomy for cardiac denervation in patients with life-threatening ventricular arrhythmias.
We reported the outcomes of a single-institution experience using video-assisted thoracoscopic left cardiac sympathetic denervation as an adjunctive therapeutic technique in pediatric and young adult patients with life-threatening ventricular arrhythmias. ⋯ Video-assisted thoracoscopic left cardiac sympathetic denervation can be safely and effectively performed in most patients with life-threatening ventricular arrhythmias. This minimally invasive procedure is a promising adjunctive therapeutic option that achieves a beneficial response in most symptomatic patients. These results support the inclusion of thoracoscopic cardiac sympathetic denervation among the treatment armamentarium in all patients with ventricular arrhythmias refractive to conventional medical therapy.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Outcomes of surgical aortic valve replacement in moderate risk patients: implications for determination of equipoise in the transcatheter era.
To determine the contemporary outcomes of surgical aortic valve replacement (SAVR) in a moderate surgical risk population. ⋯ SAVR in moderate-risk patients is currently performed with one half of the early predicted risk (2.8%) and a low likelihood of complications, including a 1.8% incidence of stroke. Patients counseled for randomization to transcatheter aortic valve insertion should be informed of the excellent early to mid-term outcomes of SAVR, particularly those without pulmonary impairment, peripheral vascular disease, or atrial fibrillation.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Long-term patient and allograft outcomes of renal transplant recipients undergoing cardiac surgery.
Cardiovascular complications are a major cause of morbidity and mortality among renal transplant recipients. This study assessed perioperative risk factors for mortality and long-term outcomes in renal transplant recipients who underwent cardiac surgery. ⋯ Cardiac surgery in patients receiving renal transplant who have functioning allograft has acceptable outcomes. If combined procedures are required, patients should be carefully considered. Transient postoperative renal impairment, even if resolved at discharge, increases the risk for allograft failure during long-term follow-up.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Thoracic aortic surgery: an overview of 40 years clinical practice.
The objective of our study was to report on the total experience in thoracic aortic surgery over a 40-year time period for a single institution. ⋯ Thoracic aortic operations were performed increasingly during a 40-year time period. Early mortality decreased and late survival increased significantly in all patient groups. A significant proportion of patients required multiple operations.