The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2024
Long-Term Results Of Atrial Fibrillation Surgery Concomitant With Mitral Valve Surgery: A Propensity Score-Matched Multicenter Study.
The aim of the study was to elucidate the long-term outcomes of atrial fibrillation surgery in patients with atrial fibrillation and mitral valve disease by comparing the patients who underwent mitral valve surgery with and without atrial fibrillation surgery. ⋯ In patients with atrial fibrillation and mitral valve disease, mitral valve surgery concomitant with atrial fibrillation surgery was associated with lower mortality, cardiac mortality, major adverse cardiac and cerebrovascular events, and stroke or transient ischemic attack up to 15 years after surgery when compared with mitral valve surgery without atrial fibrillation surgery.
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J. Thorac. Cardiovasc. Surg. · Jan 2024
Surgery and Transcatheter Intervention for Degenerative Mitral Regurgitation in The United States.
We evaluated practice trends and 3-year outcomes of transcatheter edge-to-edge repair (TEER) and surgical repair for degenerative mitral regurgitation (MR) in the U.S. ⋯ Among Medicare beneficiaries with degenerative MR, an increase in TEER utilization was associated with decreased surgical case volume, while overall mitral interventions volume was unchanged. Randomized trials are needed to better inform treatment choice.
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J. Thorac. Cardiovasc. Surg. · Jan 2024
Prognostic significance of preoperative exercise tolerance in patients with early-stage lung cancer.
To investigate the influence of simple preoperative exercise tests as prognostic factors for early-stage lung cancer. ⋯ Preoperative exercise ability is a prognostic factor for early-stage lung cancer. Patients who can tolerate an exercise load of 7 metabolic equivalents of task, even if they are aged 70 years or older, have a better prognosis than patients younger than age 70 years without exercise tolerance.
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J. Thorac. Cardiovasc. Surg. · Jan 2024
Optimized strategy to improve the outcomes of acute type A aortic dissection with malperfusion syndrome.
The mortality of acute type A aortic dissection (ATAAD) with malperfusion syndrome (MPS) is high. However, the management strategy remains controversial. We aimed to evaluate the strategy for MPS at our institution. ⋯ The optimized strategy significantly improved the outcomes of MPS. The 6-hour threshold from symptom onset could be very useful in determining the timing of central repair. For patients with MPS symptom onset within 6 hours, immediate central repair is reasonable; for those with symptom onset beyond 6 hours, individualized delayed central repair should be considered.
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J. Thorac. Cardiovasc. Surg. · Jan 2024
Simulation-Based Design of Bicuspidization of the Aortic Valve.
Severe congenital aortic valve pathology in the growing patient remains a challenging clinical scenario. Bicuspidization of the diseased aortic valve has proven to be a promising repair technique with acceptable durability. However, most understanding of the procedure is empirical and retrospective. This work seeks to design the optimal gross morphology associated with surgical bicuspidization with simulations based on the hypothesis that modifications to the free edge length cause or relieve stenosis. ⋯ Free edge length 1.5d or greater was required to avoid aortic stenosis in simulations. Cases with free edge length 1.7d or greater showed excessive billow and other changes in gross morphology. Cases with free edge length 1.5d to 1.6d have a total free edge length approximately equal to the annular circumference and appeared optimal. These effects should be studied in vitro and in animal studies.