The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2016
Allografts in aortic position: Insights from a 27-year, single-center prospective study.
Over the past decades, the indication for allograft implantation in aortic position has evolved. The purpose of this study is to report long-term survival, allograft durability, and potential risk factors. ⋯ After almost 3 decades of experience with allografts in aortic position, the indication for use has become selective, mainly because of progressive structural valve deterioration over time. In case of complex aortic root pathology and active endocarditis allografts may still be useful.
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J. Thorac. Cardiovasc. Surg. · Dec 2016
Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement.
Moderate (MHCA) versus deep (DHCA) hypothermia for circulatory arrest in aortic arch surgery has been purported to reduce coagulopathy and bleeding complications, although there are limited data supporting this claim. This study aimed to compare bleeding-related events after aortic hemiarch replacement with MHCA versus DHCA. ⋯ MHCA compared with DHCA during hermiarch replacement may slightly reduce perioperative blood-loss and plasma transfusion requirement, although these differences do not translate into reduced reoperation for bleeding or postoperative mortality and morbidity.
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J. Thorac. Cardiovasc. Surg. · Dec 2016
Outcome of aortic arch reconstruction in infants with coarctation: Importance of operative approach.
Coarctation with hypoplastic aortic arch can be treated with resection and extended end-to-end anastomosis (REEEA) as well as end-to-side anastomosis (ESA). The aim of the study was to review our experience with these techniques in newborns and infants and to assess mid-term outcome with regards to morbidity, mortality, and reintervention rate in relation to operative access and technique. ⋯ REEEA and ESA were safe and effective treatments in newborns and infants. In borderline cases, aortic arch reconstruction should be performed through a median sternotomy on bypass.
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J. Thorac. Cardiovasc. Surg. · Dec 2016
Exploring the learning curve for minimally invasive sutureless aortic valve replacement.
The study objective was to assess the learning process and quality of care of right minithoracotomy aortic valve replacement with a sutureless bioprosthesis at a single institution. ⋯ Right minithoracotomy sutureless valve implantation can be performed safely without learning curve effects. Cumulative sum analysis is a valuable tool to describe and monitor the learning process. The analysis can identify periods of less than expected performance and alert the team to react.
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J. Thorac. Cardiovasc. Surg. · Dec 2016
Assessment of thrombosis in right internal jugular vein after percutaneous superior vena cava catheter insertion during cardiovascular surgery with cardiopulmonary bypass.
We evaluated the incidence of percutaneous superior vena cava catheter-related thrombosis and identified risk factors for developing the condition in patients undergoing cardiovascular surgery with cardiopulmonary bypass. ⋯ The incidence of percutaneous superior vena cava catheter-related thrombosis was higher than conventional central venous catheter-related thrombosis. Risk factors were age, superior vena cava catheter indwelling duration, and amount of transfusion platelet concentrate.