The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Meta AnalysisSystematic review and meta-analysis of chordal replacement versus leaflet resection for posterior mitral leaflet prolapse.
To compare outcomes of chordal replacement versus leaflet resection techniques for repair of isolated posterior mitral leaflet prolapse. ⋯ Chordal replacement may be associated with greater freedom from reoperation and may lead to improved postoperative left ventricular function compared with leaflet resection. However, these conclusions are supported primarily by data from unadjusted observational studies, and high-quality RCTs of chordal replacement versus leaflet resection are needed.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Multicenter StudyImprovement in TNM staging of pulmonary neuroendocrine tumors requires histology and regrouping of tumor size.
Neuroendocrine tumors of the lung are currently staged with the 7th edition TNM non-small cell lung cancer staging system. This decision, based on data analysis without data on histology or disease-specific survival, makes its applicability limited. This study proposes a specific staging system for these tumors. ⋯ Incorporating histology and regrouping tumor stage create a unique neuroendocrine tumor staging system that seems to predict survival better than the 7th TNM classification.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Limited root repair in acute type A aortic dissection is safe but results in increased risk of reoperation.
Management of the aortic root is a challenge for surgeons treating acute type A aortic dissection. ⋯ Limited root repair was associated with increased risk of late reoperation after repair of acute type A aortic dissection. Surgeons with adequate experience may consider aortic root replacement in well-selected patients. However, given good outcomes after limited root repair, surgeons should not feel compelled to perform this more-complex operation.
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J. Thorac. Cardiovasc. Surg. · Jan 2018
Minimally invasive coronary artery bypass grafting with bilateral internal thoracic arteries: Will this be the future?
The aim was to show that total arterial revascularization via a left minithoracotomy using bilateral internal thoracic arteries was not only feasible but also a safe and reproducible procedure with excellent midterm outcomes. ⋯ Multivessel total arterial revascularization was performed using the left internal thoracic artery-right internal thoracic artery Y composite conduit via a left minithoracotomy and showed that it was safe and reproducible. The midterm outcomes have been good, and coronary angiograms showed widely patent grafts. This novel technique may help optimize minimally invasive coronary surgery and the use of bilateral internal thoracic arteries. Further, this technique has the potential for decreased morbidity, shorter hospital stay, cosmesis, and earlier return to active life.