The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2020
Prospective, multicenter, international phase 2 trial evaluating ultrasonic energy for pulmonary artery branch sealing in video-assisted thoracoscopic surgery lobectomy.
The study objectives were to evaluate the immediate, short-, and medium-term efficacy and safety of pulmonary artery branch sealing using an ultrasonic vessel-sealing device in minimally invasive anatomic lung resection. ⋯ Pulmonary artery branch sealing with ultrasonic energy during video-assisted thoracoscopic surgery lobectomy is safe for vessels 7 mm or less. The use of an ultrasonic device is a reasonable sealing method for pulmonary artery branches 7 mm or less.
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J. Thorac. Cardiovasc. Surg. · Jan 2020
Trends and outcomes of red blood cell transfusion in patients undergoing transcatheter aortic valve replacement in the United States.
To examine temporal trends, predictors, and outcomes of red blood cell (RBC) transfusion in patients undergoing transcatheter aortic valve replacement (TAVR) in the United States. ⋯ RBC transfusion is associated with worse clinical outcomes in TAVR patients without bleeding, but not in those with overt bleeding. The utility and optimal threshold for RBC transfusion in TAVR patients, especially among those with overt bleeding, warrants further prospective investigation.
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J. Thorac. Cardiovasc. Surg. · Jan 2020
Apical myectomy for patients with hypertrophic cardiomyopathy and advanced heart failure.
In patients with apical hypertrophic cardiomyopathy, extensive apical hypertrophy may reduce left ventricular end-diastolic volume and contribute to diastolic dysfunction, angina, and ventricular arrhythmias. Transapical myectomy to augment left ventricular cavity size can increase stroke volume and decrease left ventricular end-diastolic pressure. In this study, we describe early outcomes of patients with apical hypertrophic cardiomyopathy after transapical myectomy and compare survival with that of patients with hypertrophic cardiomyopathy listed for heart transplantation. ⋯ Apical myectomy is beneficial in severely symptomatic patients with apical hypertrophic cardiomyopathy. Early risk of the procedure is low, and approximately 76% maintain clinical improvement with resolution of symptoms. Long-term survival appears better than for patients listed for heart transplantation.
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The neonatal arterial switch operation is currently the procedure of choice for patients with transposition of the great arteries. However, a large number of patients present too late for the arterial switch operation and are best managed with the atrial switch operation. ⋯ The use of the Mustard operation, particularly the modified technique should play an important role in treating late-presenting patients with transposition of the great arteries. Improving the pattern of filling of the left ventricle could enhance the long-term results of the Mustard operation.