The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Mechanical or Biological Prosthesis for Aortic Valve Replacement in Patients Aged 45 to 74 Years.
The selection of valve prostheses for patients undergoing surgical aortic valve replacement remains controversial. In this study, we compared the long-term outcomes of patients undergoing aortic valve replacement with biological or mechanical aortic valve prostheses. ⋯ Compared with bioprostheses, mechanical aortic valves are associated with a lower adjusted risk of long-term mortality in patients aged 70 years or less. Patients aged less than 70 years undergoing surgical aortic valve replacement should be informed of the potential survival benefit of mechanical valve substitutes.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Mitral Valve Repair with Leaflet Resection versus Preservation for Degenerative Posterior Leaflet Prolapse.
The optimal technique for repairing posterior mitral valve leaflet prolapse remains undetermined. We aimed to compare leaflet resection and neochordae implantation in patients undergoing mitral valve repair for posterior leaflet prolapse, focusing on transmitral pressure gradient and recurrence of mitral regurgitation. ⋯ Leaflet resection yielded similar clinical outcomes and transmitral pressure gradients compared with neochordae implantation after mitral valve repair, with a lower mitral regurgitation recurrence rate. These findings underscore the need to reassess the efficacy of neochordae implantation relative to leaflet resection.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Long-Term Impact of Anatomic Subtype in Hypoplastic Left Heart Syndrome after Fontan Completion.
Aortic atresia (AA)/mitral stenosis (MS) is a well-known risk factor for survival after Norwood; however, the effect of anatomical subtypes in those who survive surgical palliation is unknown. ⋯ The survival risk of the anatomic subtype AA/MS persisted long term after Fontan completion and was likely due to a greater rate of single ventricle rather than AVV failure. These findings suggest that the abnormal pressure overload condition of the hypoplastic left ventricle created by AA/MS has a detrimental effect on single right ventricle function.