The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2017
WebcastsTricuspid regurgitation is uncommon after mitral valve repair for degenerative diseases.
To determine the incidence and effects of tricuspid regurgitation (TR) after surgery for mitral valve (MV) repair for mitral regurgitation (MR) due to degenerative disease. ⋯ Preoperative TR in patients with MR due to degenerative diseases was associated with longstanding MV disease and adversely affected long-term survival after MV repair. New postoperative TR was uncommon. The findings of this study are compelling reasons to repair the MV before the development of TR.
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J. Thorac. Cardiovasc. Surg. · Jul 2017
EditorialEvidence for thymectomy in myasthenia gravis: Getting stronger?
Thymectomy is part of the therapeutic armamentarium for myasthenia gravis (MG). During the past 80 years, multiple observational studies have shown that thymectomy can potentially fasten stabilization of the disease, reduce the need for corticosteroids, and in some patients lead to complete remission. The benefit from thymectomy in MG is supported by propensity score analysis. ⋯ In the future, better definition of the type of thymectomy will be important, particularly if prospective studies and randomized trials are performed to compare different surgical approaches. One possibility would be to reserve the term "extended thymectomy" to resection of the thymus with the anterior mediastinal fat between both pleura, the pericardium and diaphragm. More extensive surgery should be specified when it encompasses sites such as the right and left pericardiophrenic angles, the aortopulmonary window, the aortocaval groove and retroinnominate space, and the perithyroid area.
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J. Thorac. Cardiovasc. Surg. · Jul 2017
Value of surgery for infective endocarditis in dialysis patients.
To determine the value of surgery for infective endocarditis (IE) in patients on hemodialysis by comparing the nature and invasiveness of endocarditis in hemodialysis and nonhemodialysis patients and their hospital and long-term outcomes, and identifying risk factors for time-related mortality after surgery. ⋯ Intermediate-term survival after surgery for IE in hemodialysis patients is substantially worse than that in nonhemodialysis patients, but only slightly worse than that in the general hemodialysis population and substantially better than that in hemodialysis patients with IE treated nonsurgically, supporting continued surgical intervention for IE.
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J. Thorac. Cardiovasc. Surg. · Jul 2017
The miniaturized pediatric continuous-flow device: Preclinical assessment in the chronic sheep model.
The Infant Jarvik 2015 is an implantable axial-flow ventricular assist device (VAD) that has undergone the major evolutionary design modifications to improve hemocompatibility. This study was conducted in anticipation of data submission to the US Food and Drug Administration to obtain Investigational Device Exemption approval. ⋯ This study has demonstrated that the Infant Jarvik 2015 VAD is capable of maintaining its functionality for an extended period of time with minimal hemolysis.