The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Can We Safely Expand the DCD Donor Heart Pool by Extending the Donor Age Limit?
This study evaluates the impact of donor age on outcomes following donation after circulatory death heart transplantation. ⋯ The use of appropriately selected donation after circulatory donors aged 40 years or more has similar survival compared with that of younger donors. With careful candidate risk stratification and selection, consideration of using donation after circulatory donors aged more than 40 years may further ameliorate ongoing organ shortage with comparable early post-transplant outcomes.
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Impact of permanent pacemaker for iatrogenic atrioventricular block on outcomes after congenital heart surgery.
The need for permanent pacemaker (PPM) for iatrogenic atrioventricular block (AVB) after congenital heart surgery is approximately 1%. We aimed to evaluate the long-term outcomes of patients with PPM for iatrogenic AVB and compare them with patients with an optimal repair (trivial/no residual) Residual Lesion Score (RLS) Class 1 repair without PPM need. ⋯ Compared with patients with an optimal repair without PPM, patients with PPM for iatrogenic AVB are at greater risk of developing moderate or greater ventricular dysfunction and have lower transplant-free survival.
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Impact of Surgical Strategy and Post-Repair Transverse Aortic Arch Size on Late Hypertension After Coarctation Repair During Infancy.
Late hypertension (HTN) after coarctation of the aorta (CoA) repair contributes to higher morbidity and mortality. An association between transverse aortic arch (TAA) hypoplasia and HTN has been found, but its relationship with surgical strategy is unclear. We studied the association between late HTN and initial surgical strategy pertaining to the TAA. ⋯ In patients undergoing surgical repair of CoA during infancy, late HTN was not associated with immediate postrepair TAA size or surgical strategy pertaining to the TAA. These results suggest that factors other than surgical strategy, such as differential growth of the TAA during childhood, may be important.
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J. Thorac. Cardiovasc. Surg. · Feb 2025
Outcomes of Aortic Surgery in Patients with Takayasu Arteritis.
To investigate the presentation, aortic involvement, and surgical outcomes in patients with Takayasu arteritis undergoing aortic surgery. ⋯ Ascending aorta aneurysm and aortic valve regurgitation are the most frequent presentations in patients with Takayasu arteritis requiring aortic surgery. Surgery in these individuals is safe, with acceptable short- and long-term results.
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Segmentectomy is becoming the standard of care for small, peripheral non-small cell lung cancer. To improve perioperative management in this population, this study aims to identify factors influencing hospital length of stay after segmentectomy. ⋯ Older patients, those with reduced pulmonary function, and current and past smokers have elevated risk for prolonged hospital stays after segmentectomy. Validation of our nomogram could improve perioperative risk stratification in patients who undergo segmentectomy.