The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Controlled Clinical TrialTranscoronary infusion of cardiac progenitor cells in hypoplastic left heart syndrome: Three-year follow-up of the Transcoronary Infusion of Cardiac Progenitor Cells in Patients With Single-Ventricle Physiology (TICAP) trial.
Our aim was to assess midterm safety and clinical outcomes of intracoronary infusion of cardiosphere-derived cells (CDCs) after staged palliation in patients with hypoplastic left heart syndrome (HLHS). ⋯ Intracoronary CDC infusion after staged procedure in patients with HLHS is safe and improves RVEF, which persists during 36-month follow-up. This therapeutic strategy may enhance somatic growth and reduce incidence of heart failure.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Prophylactic stage 1 elephant trunk for moderately dilated descending aorta in patients with predominantly proximal disease.
Staged elephant trunk (ET) repair is a commonly performed procedure for extensive aortic disease. A significant proportion of patients with predominantly proximal aortic pathology often have in addition a moderately dilated descending aorta (<5 cm) that can progress over time. Objectives were to characterize patients, determine completion rate after prophylactic stage 1 ET, and assess outcomes. ⋯ Prophylactic ET for moderately dilated descending aorta is an effective strategy for staged repair, especially in patients with chronic dissection, connective tissue disorder, and aortitis. In addition, this approach can be beneficial for emergency treatment of late distal aortic complications.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Comparative StudyComparison of perfusion and thickening between vein and right internal thoracic artery composite grafts from a randomized trial substudy.
Improvements in myocardial perfusion and thickening were compared in coronary artery bypass grafting patients who received saphenous vein (SV) Y-composite grafts versus those who received right internal thoracic artery ([R]ITA) Y-composite grafts. ⋯ Improvements in myocardial perfusion and segmental myocardial thickening were similar between the 2 groups at 1 year after revascularization. The SV, versus the right ITA, composite graft may be more beneficial in perfusion improvement of the right coronary artery territory.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Comparative StudyContemporary outcomes of surgery for aortic root aneurysms: A propensity-matched comparison of valve-sparing and composite valve graft replacement.
The study objective was to give an overview of the current state of the art of the surgical treatment of aortic root pathologies in a high-volume center. ⋯ In the current era, aortic root replacement can be performed with low perioperative risk in high-volume aortic centers. The type of operation performed does not affect early or late survival. Although the mechanical composite valved graft remains the gold standard for durability, the biologic composite valved graft and valve-sparing reconstruction are excellent options for those who cannot take or want to avoid long-term anticoagulation.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Clinical TrialOne-year clinical and angiographic results of hybrid coronary revascularization.
To evaluate 1-year clinical and angiographic results after hybrid coronary revascularization (HCR) combining off-pump left internal mammary artery (LIMA) grafting through an inferior J-hemisternotomy with percutaneous coronary intervention (PCI). ⋯ Angiographically controlled HCR was associated with a high repeat revascularization rate. The 1-year 98% LIMA-graft patency rate, and low risk of death and stroke, seem promising for the long-term outcome. Non-left anterior descending coronary artery lesion revascularization remains a challenge.