The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Comparative StudyComparison of perfusion and thickening between vein and right internal thoracic artery composite grafts from a randomized trial substudy.
Improvements in myocardial perfusion and thickening were compared in coronary artery bypass grafting patients who received saphenous vein (SV) Y-composite grafts versus those who received right internal thoracic artery ([R]ITA) Y-composite grafts. ⋯ Improvements in myocardial perfusion and segmental myocardial thickening were similar between the 2 groups at 1 year after revascularization. The SV, versus the right ITA, composite graft may be more beneficial in perfusion improvement of the right coronary artery territory.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Prophylactic stage 1 elephant trunk for moderately dilated descending aorta in patients with predominantly proximal disease.
Staged elephant trunk (ET) repair is a commonly performed procedure for extensive aortic disease. A significant proportion of patients with predominantly proximal aortic pathology often have in addition a moderately dilated descending aorta (<5 cm) that can progress over time. Objectives were to characterize patients, determine completion rate after prophylactic stage 1 ET, and assess outcomes. ⋯ Prophylactic ET for moderately dilated descending aorta is an effective strategy for staged repair, especially in patients with chronic dissection, connective tissue disorder, and aortitis. In addition, this approach can be beneficial for emergency treatment of late distal aortic complications.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Comparative StudyLate outcomes after the Cox maze IV procedure for atrial fibrillation.
The Cox maze IV procedure (CMPIV) has been established as the gold standard for surgical ablation; however, late outcomes using current consensus definitions of treatment failure have not been well described. To compare to reported outcomes of catheter-based ablation, we report our institutional outcomes of patients who underwent a left-sided or biatrial CMPIV at 5 years of follow-up. ⋯ The outcomes of the CMPIV remain good at late follow-up. The type of preoperative AF or the addition of a concomitant procedure did not affect late success. The results of the CMPIV remain superior to those reported for catheter ablation and other forms of surgical AF ablation, especially for patients with persistent or longstanding AF.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Comparative StudyThe long-term impact of various techniques for tricuspid repair in Ebstein's anomaly.
We describe a repertoire of repair techniques according to type of Ebstein's anomaly to correct tricuspid valve (TV) incompetence, and report long-term ventricular function and functional outcomes. ⋯ The various repair techniques, all of which preserve the atrialized chamber and are used individually according to morphology, provide satisfactory long-term ventricular function and functional outcome even in severe types of Ebstein's anomaly.