The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2014
Trends in aortic clamp use during coronary artery bypass surgery: effect of aortic clamping strategies on neurologic outcomes.
The purpose of the present study was to determine the effect of different clamping strategies during coronary artery bypass grafting on the incidence of postoperative stroke. ⋯ During on-pump coronary artery bypass grafting, the use of a single crossclamp compared with the double clamp technique decreased the risk of postoperative stroke. The use of any aortic clamp decreased and epiaortic ultrasound use increased from 2002 to 2009, indicating a change in the operative technique and surgeon awareness of the potential complications associated with manipulation of the aorta.
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J. Thorac. Cardiovasc. Surg. · Feb 2014
Sutureless replacement versus transcatheter valve implantation in aortic valve stenosis: a propensity-matched analysis of 2 strategies in high-risk patients.
This propensity-matched study compared clinical and echocardiographic outcomes between patients undergoing transcatheter aortic valve implantation (TAVI) and sutureless aortic valve replacement. ⋯ Combining the advantage of standard diseased valve removal with shorter procedural times, minimally invasive sutureless aortic valve replacement may be the first-line treatment for high-risk patients considered in the "gray zone" between TAVI and conventional surgery.
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J. Thorac. Cardiovasc. Surg. · Feb 2014
Treatment strategies for left subclavian artery during total arch replacement combined with stented elephant trunk implantation.
One of the technical challenges in total arch replacement for type A aortic dissection is the left subclavian anastomosis and the descending aortic anastomosis. We present a technique that simplifies this surgery. ⋯ The left subclavian artery bypass technique during total arch replacement for type A dissection is reliable and simplifies the surgery by bringing the descending aortic anastomosis more proximal and eliminating the difficult left subclavian artery anastomosis.
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J. Thorac. Cardiovasc. Surg. · Feb 2014
Comparative Study Observational StudyEffects of the side of arteriovenous fistula on outcomes after coronary artery bypass surgery in hemodialysis-dependent patients.
The aim of the study was to determine whether using the in situ internal thoracic artery (ITA) graft ipsilateral to the arteriovenous fistula adversely affects the outcomes after isolated coronary artery bypass grafting (CABG) in the dialysis-dependent patients to answer the concerns of a possible steal and consequent myocardial ischemia. ⋯ Revascularization of the LAD using the in situ ITA graft ipsilateral to the arteriovenous fistula increases neither the operative mortality nor the risks of late death and cardiac events after isolated CABG in dialysis patients.
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J. Thorac. Cardiovasc. Surg. · Feb 2014
Vibration response imaging versus perfusion scan in lung cancer surgery evaluation.
Ventilation/perfusion scan is a standard procedure in high-risk surgical patients to predict pulmonary function after surgery. Vibration response imaging is a technique that could be used in these patients. The objective of our study was to compare this imaging technique with the usual scanning technique for predicting postoperative forced expiratory volume. ⋯ The 2 techniques presented good concordance values. Vibration response imaging shows non-negligible confidence intervals. Vibration response imaging may be useful in preoperative algorithms in patients before lung cancer surgery.