The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2020
Two different geometric orientations for aortic neoroot creation in bicuspid aortic valve repair with root reimplantation.
Bicuspid aortic valve (BAV) represents 2 cusps oriented along a spectrum of equal (180°/180°) or unequal (150°/210°) leaflet surface area distribution along the aortic annular plane. We have taken the approach of respecting the native geometric orientation of the repaired BAV leaflets when creating the aortic neoroot during valve-sparing root reimplantation (VSRR) procedures. We investigated midterm outcomes with this 2-prong approach for VSRR in BAV syndrome. ⋯ Respecting BAV geometry for VSRR neoroot creation yields excellent midterm outcomes and may minimize conjoint cusp leaflet stress that may occur in "forcing" a 150°/210° type I BAV into a 180°/180° neoroot.
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J. Thorac. Cardiovasc. Surg. · Jul 2020
Is previous cardiac surgery a risk factor for open repair of acute type A aortic dissection?
The study objective was to determine the optimal treatment for patients with acute type A aortic dissection and previous cardiac surgery. ⋯ Acute type A aortic dissection in patients with previous cardiac surgery can be repaired with favorable operative mortality and long-term survival, and should be treated surgically.
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J. Thorac. Cardiovasc. Surg. · Jul 2020
The effect of age on survival after endoscopic resection versus surgery for T1a esophageal cancer.
Endoscopic resection has emerged as a treatment option for T1a esophageal cancer, but the impact of age on patient selection for surgery versus endoscopic resection has not been well studied. We hypothesized that endoscopic resection would be associated with improved survival compared with surgery in older patients with early esophageal cancer and worse survival in younger patients. ⋯ Endoscopic resection was associated with similar survival compared with surgery in patients with cT1a esophageal cancer regardless of age. Endoscopic resection can be considered for patients at low risk of nodal involvement across all age groups as an alternative to surgery for T1a esophageal cancer.
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J. Thorac. Cardiovasc. Surg. · Jul 2020
The influence of coronary artery anatomy on mortality after the arterial switch operation.
We sought to determine the influence of coronary artery anatomy on mortality in more than 1000 children undergoing the arterial switch operation. ⋯ Patients with anomalous coronary artery anatomy had higher rates of early mortality after the arterial switch operation but this was not statistically significant. Coronary artery reoperations were rare.
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J. Thorac. Cardiovasc. Surg. · Jul 2020
Entire mitral reconstruction with porcine extracellular matrix in an acute porcine model.
The objective of our study was to investigate the feasibility of reconstructing the entire mitral valvular and subvalvular apparatus in pigs using a modified tube graft design made of 2-ply small intestinal submucosa extracellular matrix. ⋯ In this acute porcine study, entire mitral valvular and subvalvular apparatus reconstruction using a modified tube graft design made from 2-ply small intestinal submucosal extracellular matrix was feasible. The 2-ply small intestinal submucosa extracellular matrix could withstand the pressure exerted by the left ventricle without any signs of tearing or rupture. These promising results warrant further assessment of both the annular geometry and the long-term durability.