The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Mar 2017
Randomized Controlled Trial Multicenter StudyDevelopment and impact of arrhythmias after the Norwood procedure: A report from the Pediatric Heart Network.
The study objective was to determine the predictors of new-onset arrhythmia among infants with single-ventricle anomalies during the post-Norwood hospitalization and the association of those arrhythmias with postoperative outcomes (ventilator time and length of stay) and interstage mortality. ⋯ Tachyarrhythmias are common after the Norwood procedure, but atrioventricular block may portend a greater risk for interstage mortality.
-
J. Thorac. Cardiovasc. Surg. · Mar 2017
Multicenter Study Observational StudyEarly hemodynamics and clinical outcomes of isolated aortic valve replacement with stentless or transcatheter valve in intermediate-risk patients.
Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. The aim of the current multi-institutional study was to compare hemodynamics of transcatheter (TAVR) and the Freedom SOLO Stentless (FS) valve in an intermediate risk population undergoing surgical aortic valve replacement. ⋯ In patients with small aortic annulus and intermediate risk, both FS and TAVR demonstrated similar excellent hemodynamic performance. TAVR demonstrated greater mortality and rates of pacemaker insertion. Further studies are warranted to validate TAVR indications in this subset of patients.
-
J. Thorac. Cardiovasc. Surg. · Mar 2017
Multicenter Study Observational StudyMidterm, multicenter clinical and hemodynamic results for the Trifecta aortic pericardial valve.
To evaluate the midterm hemodynamic performance and clinical outcomes of the Trifecta aortic pericardial valve. ⋯ These midterm results demonstrate that the Trifecta valve is a safe and effective valve substitute with excellent hemodynamic performance and durability that is maintained through the 6-year follow-up period.
-
J. Thorac. Cardiovasc. Surg. · Mar 2017
Multicenter Study Observational StudyLiver health in adults with Fontan circulation: A multicenter cross-sectional study.
Liver disease is an important contributor to morbidity and mortality in patients after Fontan surgery. There has been no large-scale survey of liver health in this population. We sought to explore the prevalence and predictors of liver disease in a multicenter cohort of adults with Fontan physiology. ⋯ Regardless of modality, findings of liver disease are common among adults with Fontan circulation, even those appearing clinically well. Cirrhosis is present in up to one-third of subjects. Correlations between hepatic fibrosis stage and clinical history or findings on noninvasive testing are few. Further research is needed to identify patients at risk for more severe liver disease and to determine the best methods for assessing liver health in this population.