The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2017
Feasibility of intraoperative water testing in aortic valve repair: Direct visualization from left ventricle with a videoscope.
We describe a simple method to assess the aortic valve using a videoscope inserted in the left ventricle (LV-VS) during valve-sparing root replacement. The aim of this study was to evaluate the feasibility of this technique by comparing it with the findings of postoperative transesophageal echocardiography (TEE). ⋯ Intraoperative direct inspection with LV-VS is a feasible method for confirming the completion of cusp repair.
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J. Thorac. Cardiovasc. Surg. · Jul 2017
WebcastsTopographic mapping of left ventricular regional contractile injury in ischemic mitral regurgitation.
Restrictive leaflet tethering resulting from regional left ventricular (LV) contractile injury causes ischemic mitral regurgitation (MR). We hypothesized that 3-dimensional LV topographic mapping by MRI-based multiparametric strain analysis could characterize the regional contractile injury patterns that differentiate ischemic coronary artery disease patients who have ischemic MR from those who do not. ⋯ Multiparametric strain analysis demonstrated severe normalized contractile injury in the papillary muscle-related LV subregions in patients with ischemic MR. The mean degree of normalized injury approached 2 standard deviations and was significantly worse than the levels seen in ischemic no-MR patients.
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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
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.