The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Aortic arch isolation to reduce cerebral embolic risk during replacement of the atherosclerotic aortic arch.
To analyze the efficacy of isolating the upper body circulation from the lower body (isolation technique) in reducing the risk of embolic stroke during cardiopulmonary bypass in patients with severe atherosclerosis undergoing aortic arch surgery. ⋯ The isolation technique was associated with a significant reduction in early postoperative embolic stroke and mortality risks in patients with severe aortic atherosclerosis undergoing total arch replacement.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Impact of Preoperative Aortic Regurgitation on Long-term Autograft Durability and Dilatation in Children and Adolescents Undergoing the Ross Procedure.
Primary aortic insufficiency (AI) is a risk factor for autograft reintervention in adults undergoing the Ross procedure. We sought to examine the influence of preoperative AI on autograft durability in children and adolescents. ⋯ Children and adolescents with AI undergoing the Ross procedure have higher rates of autograft failure. Patients with preoperative AI have more pronounced dilatation at the annulus. Akin to adults, a surgical aortic annulus stabilization technique that modulates growth is needed in children.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Contemporary socioeconomic-based disparities in cardiac surgery: Are we closing the disparities gap?
Female sex and lower income residence location are associated with worse health care outcomes. In this study we analyzed the national, contemporary status of socioeconomic disparities in cardiac surgery. ⋯ Despite advances in the techniques and safety, women and patients of lower socioeconomic status continue to have worse outcomes after cardiac surgery. These persistent disparities warrant the need for root cause analysis.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Selective sinus replacement for aortic root repair in bicuspid aortopathy.
To evaluate the results after selective sinus replacement (SSR) for aortic root remodeling in bicuspid aortopathy. ⋯ Patient-tailored root repair using SSR is a very effective and durable valve-sparing approach for bicuspid aortopathy. Aortic cusp repair is decisive for both abolishment of AI in bicuspid aortopathy and for the functional durability of the repaired aortic valve.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Encouraging Results of Blood Conservation in Neonatal Open-Heart Surgery.
To report early outcomes of blood conservation in neonatal open-heart surgery. ⋯ Bloodless surgery is possible in a significant proportion of neonates undergoing open-heart surgery, including the Norwood operation, even in the early stages of experience. Early clinical results are favorable but long-term follow-up and continued efforts are warranted to prove safety and reproducibility.