The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Surgical repair of coronary artery ostial stenosis in patients with Williams and elastin arteriopathy syndromes.
Patients with Williams and elastin arteriopathy syndromes often have similar cardiac phenotypes characterized by supravalvar aortic stenosis (SVAS), peripheral pulmonary artery stenosis (PPAS), and coronary artery ostial stenosis (CAOS). SVAS and/or PPAS result in a marked increase in myocardial oxygen demand, whereas CAOS may limit myocardial oxygen supply. This combination predisposes to myocardial ischemic events and sudden cardiac arrest. The purpose of this study was to review our experience with the surgical repair of CAOS in patients with Williams and elastin arteriopathy syndromes. ⋯ The data demonstrate that patients with Williams and elastin arteriopathy syndromes presenting with SVAS and/or PPAS plus CAOS can undergo successful repair of all hemodynamic issues simultaneously.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Outflow tract geometries are associated with adverse outcome indicators in repaired tetralogy of Fallot.
A wide variety of right ventricular outflow tract (RVOT) and pulmonary artery (PA) geometries has been reported in patients with repaired tetralogy of Fallot (rTOF). We aimed to investigate the associations between RVOT/PA geometries and outcome indicators in a large rTOF cohort receiving non-conduit repair. ⋯ Distinct RVOT morphologies and branch PA size discrepancy are associated with variations in RV remodeling and exercise capacity in patients with rTOF. These findings may aid decision-making regarding reintervention for PR and branch PA size discrepancy.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Branch stent-grafting for endovascular repair of chronic aortic arch dissection.
The preliminary clinical outcomes of a novel branch stent-grafting for endovascular repair of chronic aortic arch dissection proved its safety and effectiveness. ⋯ Based on preoperatively adequate planning and accurate measurement, endovascular repair of chronic aortic arch dissection using this branched stent-graft showed a low and an acceptable incidence of complications and mortality with positive aortic remodeling, which provided a satisfactory and promising alternative treatment option.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Postoperative opioid use after lobectomy for primary lung cancer: A propensity-matched analysis of premier hospital data.
To evaluate opioid administration after robotic lobectomy (RL) compared with video-assisted thoracic surgery (VATS) and open lobectomy in patients with lung cancer. ⋯ Patients undergoing RL for primary lung cancer received opioids less frequently, and with lower total and average daily doses, compared with those undergoing VATS and open lobectomy. Studies are needed to determine whether early opioid dosage reductions translate into less chronic opioid use.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Impact of tricuspid regurgitation with and without repair during aortic valve replacement.
Long-term outcomes of aortic valve replacement (AVR) are worse in patients with tricuspid regurgitation (TR), but the impact of concomitant tricuspid valve intervention remains unclear. The purpose of this study was to determine the effect of tricuspid intervention in patients with TR undergoing AVR. ⋯ Increasing severity of TR is associated with higher rates of morbidity and mortality after AVR. Correction of TR at the time of surgical AVR is not associated with increased operative mortality and has been shown to improve long-term outcomes.