The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2022
Meta AnalysisEarly surgery versus conservative management of asymptomatic severe aortic stenosis: A meta-analysis.
Although current guidelines generally recommend watchful waiting strategy for patients with asymptomatic severe aortic stenosis until symptoms develop, early surgery for asymptomatic aortic stenosis remains controversial. This study aimed to compare the outcomes of early surgery versus conservative strategy for patients with asymptomatic severe aortic stenosis. ⋯ We demonstrated that early surgery was associated with significant reduction in all-cause and cardiovascular mortality in patients with severe aortic stenosis. Further randomized trials are warranted to confirm our findings.
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J. Thorac. Cardiovasc. Surg. · May 2022
Impact of pulmonary artery coarctation on pulmonary artery growth and definitive repair following modified Blalock-Taussig shunt.
Pulmonary artery coarctation may pose a risk for pulmonary stenosis and subsequent failure to achieve definitive repair. We sought to assess the impact of pulmonary artery coarctation on pulmonary artery growth. ⋯ Pulmonary artery coarctation affected disproportionate pulmonary artery growth throughout the staged repair, but did not result in failure of definitive repair/Fontan completion. Pulmonary artery plasty during the neonatal period did not contribute to catch-up growth of the left pulmonary artery; therefore, surgical indications and timing should be carefully considered.
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J. Thorac. Cardiovasc. Surg. · May 2022
Editorial CommentCommentary: Modified frozen elephant trunk.
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J. Thorac. Cardiovasc. Surg. · May 2022
Randomized Controlled TrialVentricular reshaping with a beating heart implant improves pump function in experimental heart failure.
The left ventricle remodels from an ellipsoidal/conical shape to a spherical shape after a myocardial infarction. The spherical ventricle is inefficient as a pumping chamber, has higher wall stresses, and can lead to congestive heart failure. We sought to investigate if restoring physiological ventricular shape with a beating heart implant improves pump function. ⋯ Reshaping a postinfarction, failing left ventricle to restore its physiological conical shape significantly improves long-term pump function.