The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2020
Comparative StudyInfluence of warfarin on cardiac and cerebrovascular events following bioprosthetic aortic valve replacement: A nationwide cohort study.
The need for anticoagulation treatment following bioprosthetic aortic valve replacement remains controversial. We investigated the associations of warfarin treatment with the risks of major adverse cardiac and cerebrovascular events, including mortality, bleeding incidents, and reoperation requirement after bioprosthetic aortic valve replacement surgery. ⋯ Short-term use of postoperative warfarin (especially <30 days) following bioprosthetic aortic valve replacement may be associated with a reduction in MACCE compared with nonuse.
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J. Thorac. Cardiovasc. Surg. · May 2020
Observational StudyEffect of β-blocker therapy on late outcomes after surgical repair of type A aortic dissection.
The objective of the study was to evaluate the effects of β-blocker therapy on long-term outcomes in patients after surgical repair of type A aortic dissection. ⋯ β-Blocker usage had a protective effect on long-term outcomes in patients after surgical repair of acute type A aortic dissection. Strict medication adherence of β-blocker therapy was associated with a survival benefit.
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J. Thorac. Cardiovasc. Surg. · May 2020
Comparative StudyRisk of adding prophylactic aorta replacement to a cardiac operation.
The study objective was to determine whether adding prophylactic aorta replacement increases the risk of a cardiac operation when cardiac rather than aortic disease is the primary indication for operation. ⋯ Prophylactic aorta replacement can be safely performed during a cardioaortic operation, without added penalty, when aortic disease is less severe and not the primary indication for surgery. Risks after an aorta replacement combined with cardiac surgery can be substantial, however, when advanced aortic disease is the primary indication for operation. These distinctive risks should be taken into consideration at the time of surgical decision-making.
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J. Thorac. Cardiovasc. Surg. · May 2020
Comparative StudyOpen surgery and endovascular repair for mycotic aortic aneurysms: Benefits beyond survival.
Endovascular techniques have been increasingly used to treat mycotic aortic aneurysms. However, apart from survival, the potential benefits of open surgery and endovascular repair for mycotic aortic aneurysms are poorly understood. The aim of this study was to evaluate the short- and mid-term outcomes after open surgery versus endovascular repair for mycotic aortic aneurysms. ⋯ There were no significant differences between endovascular repair and open surgery in survival. However, in the mid-term, the potential benefits of open surgery are favorable compared with endovascular repair, including lower infection-related reoperation rates and reduced medical burden.
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J. Thorac. Cardiovasc. Surg. · May 2020
Normalization of hemodynamics is delayed in patients with a single ventricle after pediatric heart transplantation.
The time course for hemodynamic normalization after pediatric heart transplantation has not been well characterized. We hypothesized that patients with a single ventricle would normalize later than those with dilated cardiomyopathy. Establishing the expected course based on the underlying pathophysiology will allow identification of patients who are outliers, requiring further investigation. ⋯ Patients with a single ventricle demonstrated delayed hemodynamic normalization compared with dilated cardiomyopathy heart transplant recipients, without affecting survival or need for retransplantation.