The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2017
Long-term outcomes of frozen elephant trunk for type A aortic dissection in patients with Marfan syndrome.
The use of the frozen elephant trunk (FET) technique for repair of type A aortic dissection (TAAD) in Marfan syndrome (MFS) is controversial. We seek to evaluate the efficacy of FET and total arch replacement (TAR) for TAAD in patients with MFS. ⋯ The frozen elephant trunk and total arch replacement procedure can be safely performed for TAAD in MFS with low operative mortality, favorable long-term survival and freedom from reoperation. A concomitant Bentall procedure was predictive of better long-term survival and increased risk for late reoperation. These results argue favorably for the use of the FET + TAR technique in the management of TAAD in patients with MFS.
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J. Thorac. Cardiovasc. Surg. · Oct 2017
Concomitant mitral repair and continuous-flow left ventricular assist devices: Is it warranted?
Pre-existing mitral pathology is common in patients undergoing continuous-flow left ventricular assist device implantation. We sought to investigate whether concurrent mitral repair confers any advantage. ⋯ Concurrent mitral repair appears to be efficacious in controlling MR after device implant. The fact that repaired patients developed late right heart failure less frequently than did patients without repair challenges the notion that concurrent mitral repair is unwarranted.
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J. Thorac. Cardiovasc. Surg. · Oct 2017
Randomized Controlled TrialOperative strategies to reduce cerebral embolic events during on- and off-pump coronary artery bypass surgery: A stratified, prospective randomized trial.
To determine the impact of different aortic clamping strategies on the incidence of cerebral embolic events during coronary artery bypass grafting (CABG). ⋯ For patients with low-grade aortic disease, the use of CFDs was associated with an increased rate of cerebral embolic events compared with partial clamping during off-pump CABG. A single-clamp strategy during on-pump CABG did not significantly reduce embolic events compared with a double-clamp strategy.