The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2023
Long-Term Survival, Cardiovascular, and Functional Outcomes after Minimally Invasive Coronary Artery Bypass Grafting in 566 Patients.
Sternotomy has been the gold standard incision for surgical revascularization but may be associated with chronic pain and sternal malunion. Minimally invasive coronary artery bypass grafting allows for complete surgical revascularization through a small thoracotomy in selected patients. There is a paucity of long-term data, particularly functional outcomes, for patients who underwent minimally invasive coronary artery bypass grafting. ⋯ Minimally invasive coronary artery bypass grafting is a safe and durable alternative to sternotomy coronary artery bypass grafting in selected patients, with excellent short- and long-term outcomes, including for multivessel coronary disease. At long-term follow-up, the proportion of patients with significant symptoms and incisional pain was low.
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J. Thorac. Cardiovasc. Surg. · Aug 2023
The Fate of Concomitant Tricuspid Regurgitation in Patients Undergoing Coronary Artery Bypass Grafting.
Owing to a lack of supportive data, tricuspid regurgitation (TR) is usually not addressed in patients undergoing coronary artery bypass grafting (CABG). Here we evaluated changes in TR degrees over time and its impact on survival in patients undergoing CABG. ⋯ Significant preoperative TR improved in 40.5% of patients after isolated CABG. After adjusting for other factors, significant TR did not affect long-term survival.
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J. Thorac. Cardiovasc. Surg. · Aug 2023
Aortic enlargement in two weeks is associated with subsequent aortic events in patients with type B acute aortic syndrome.
To determine whether aortic enlargement in 2 weeks in patients with type B acute aortic syndrome is associated with aorta-related adverse events. ⋯ Moderate aortic enlargement in 2 weeks is a significant risk factor of aorta-related adverse events in patients with uncomplicated type B acute aortic syndrome. Patients with moderate aortic enlargement should be followed up carefully and may be candidates for subsequent endovascular treatment.
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J. Thorac. Cardiovasc. Surg. · Aug 2023
Mortality following durable left ventricular assist device implantation by timing and type of first infection.
Although infections are common after left ventricular assist device implantation, the relationship between timing and type of first infection with regard to mortality is less well understood. ⋯ Relative to those without infection, patients with any postimplantation infection had an increased risk of death. Ventricular assist device-related infections and infections occurring in the intermediate interval were associated with the largest increase in risk of death. After left ventricular assist device implantation, infection prevention strategies should target non-ventricular assist device infections in the first 90 days, then shift to surveillance/prevention of driveline infections after 90 days.