The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
Mitral valve repair versus replacement in patients with rheumatic heart disease.
Rheumatic heart disease remains a major cause of cardiovascular death worldwide. Limited real-world nationwide data are available to compare the long-term outcomes between mitral valve repair and replacement in rheumatic heart disease. ⋯ Among patients with rheumatic heart disease, mitral valve repair is not associated with superior long-term outcomes. Patients should be carefully selected for mitral valve repair because of its higher reoperation rate, particularly those with previous percutaneous transvenous mitral commissurotomy.
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
Membranous septum length predicts conduction disturbances following transcatheter aortic valve replacement.
Insufficient distance between membranous septum (MS) length and implant depth (ID) may aggravate mechanical compression of the conduction tissue by transcatheter aortic valve replacement (TAVR) prosthesis. We investigated the implication of MS length measured in the coronal view (coronal MS length) compared with infra-annular MS length from stretched vessel image to predict conduction disturbances following TAVR with CoreValve/Evolut R valves (Medtronic, Minneapolis, Minn). ⋯ Preprocedural assessment of MS length should be routinely adopted to determine the optimal ID to mitigate individual patient susceptibility to conduction disturbances after TAVR with self-expanding valves.
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
Adjunctive endovascular balloon fracture fenestration for chronic aortic dissection.
Positive remodeling after thoracic endovascular aortic repair (TEVAR) for chronic thoracic aortic dissection is variable due to incomplete distal seal and retrograde false lumen perfusion. We assessed the outcomes of adjunctive balloon fracture fenestration (BFF) during TEVAR in patients with chronic aortic dissection complicated by negative remodeling. ⋯ BFF of chronic dissection membrane is a beneficial adjunct to TEVAR during short-term follow-up and may promote positive aortic remodeling and is worthy of further study.
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
History of cancer and survival after coronary artery bypass grafting: Experiences from the SWEDEHEART registry.
To explore the currently unknown association between history of cancer at the time of coronary artery bypass grafting (CABG) and long-term survival. ⋯ The proportion of patients undergoing CABG with a history of cancer has increased over time. History of cancer at the time of surgery is associated with increased cancer deaths over time but not cardiovascular deaths. The same cardiovascular prognosis after CABG can be expected regardless of cancer history.
-
J. Thorac. Cardiovasc. Surg. · Jul 2022
Stepwise external wrapping procedure for type A intramural hematoma.
The optimal treatment for Stanford type A acute intramural hematoma remains controversial, especially in elderly or high-risk patients. ⋯ Our stepwise external wrapping is a feasible alternative to conventional graft replacement for high-risk patients with type A intramural hematoma. The early and midterm outcomes of the procedure were satisfactory, but further careful follow-up is needed.