The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2016
EditorialBioprosthetic valve thrombosis: What we know and what we need to know.
Bioprosthetic valve thrombosis account for 11% of all reoperations for bioprosthetic valve dysfunction, and preoperative diagnosis can be made based on echocardiographic features. Early reoperation can be prevented if BPVT is identified and treated preoperatively.
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J. Thorac. Cardiovasc. Surg. · Oct 2016
Review Meta AnalysisEffect of diastolic dysfunction on postoperative outcomes after cardiovascular surgery: A systematic review and meta-analysis.
The objective of this study was to investigate the effect of preoperative diastolic dysfunction on postoperative mortality and morbidity after cardiovascular surgery. ⋯ Presence of preoperative diastolic dysfunction was associated with greater postoperative mortality and major adverse cardiac events, regardless of LVEF. Mortality was significantly greater in grade III diastolic dysfunction.
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J. Thorac. Cardiovasc. Surg. · Oct 2016
Meta AnalysisRight internal thoracic artery versus radial artery as the second best arterial conduit: Insights from a meta-analysis of propensity-matched data on long-term survival.
We conducted a meta-analysis of propensity score-matching (PSM) studies comparing long-term survival of patients receiving right internal thoracic artery (RITA) versus radial artery (RA) as a second arterial conduit for coronary artery bypass grafting. ⋯ The present PSM data meta-analysis suggests that the use of RITA compared with RA was associated with superior long-term survival and freedom from repeat revascularization, with similar operative mortality and incidence of sternal wound complication when the skeletonized harvesting technique was used.
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J. Thorac. Cardiovasc. Surg. · Oct 2016
Randomized Controlled Trial Comparative StudyA randomized, prospective pilot comparison of 3 atrial appendage elimination techniques: Internal ligation, stapled excision, and surgical excision.
Elimination of the left atrial appendage (LAA) attempts to reduce stroke in patients with atrial fibrillation (AF). A retrospective review suggests that various surgical techniques are often unsuccessful and may leave a stump or gap. In a pilot study, we prospectively evaluated 3 surgical techniques with long-term follow up to define effectiveness. ⋯ LAA elimination is often incomplete and goes undetected. If the LAA is eliminated at the time of surgery, then TEE should be used intraoperatively to assess effectiveness and reintervention performed if warranted. Late assessment for completeness of closure should be considered before cessation of anticoagulation until more effective LAA techniques can be developed.