The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Fate of functional tricuspid regurgitation in aortic stenosis after aortic valve replacement.
Functional tricuspid regurgitation (TR) is found not infrequently in conjunction with aortic stenosis. The aim of the present study was to evaluate the changes in TR and to identify the predictors of late progression after aortic valve replacement. ⋯ Not only did TR in patients with aortic stenosis frequently persist after aortic valve replacement, it was progressive in some. This finding was associated with left ventricular diastolic dysfunction. A concomitant tricuspid valve procedure could be considered in selected patients with aortic stenosis to avoid late TR.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Is single-dose prophylactic gentamicin associated with acute kidney injury in patients undergoing cardiac surgery? A matched-pair analysis.
Although aminoglycoside treatment has been associated with nephrotoxic effects, single-dose gentamicin has been considered safe in surgery. However, the effect of a single-dose prophylactic aminoglycoside on the risk of acute kidney injury among patients undergoing cardiac surgery remains uncertain. ⋯ A single-dose prophylactic aminoglycoside in adult cardiac surgery patients was associated with an increased risk of acute kidney injury but not with a greater frequency of postoperative dialysis or mortality. No differences in the incidence of sternal infections between groups were observed.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Preoperative heart failure in the Medicare population undergoing mitral valve repair and replacement: an opportunity for improvement.
Elderly patients are under-represented in most surgical series of mitral valve surgery. The impact of preoperative heart failure (HF) on the outcomes of this subset has not been extensively studied. ⋯ Preoperative HF is present in a large number of elderly patients undergoing primary isolated mitral valve surgery and adversely affects their short-term and long-term survival, irrespective of procedure type (repair or replacement). The study supports the early identification of elderly patients with mitral valve disease and referral to surgery before the onset of HF.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
A novel and simple technique for correction of posterior leaflet prolapse due to chordal elongation or rupture.
The study objective was to evaluate the midterm results of a technique for correction of posterior leaflet prolapse without resection or use of artificial chordae. ⋯ Although the rationale for the use of the U technique is different from what is generally accepted, the midterm results of this approach are comparable to those obtained with more conventional techniques, remaining stable after a mean follow-up of 18 months.
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J. Thorac. Cardiovasc. Surg. · Oct 2014
Minimally invasive mitral valve repair in Barlow's disease: early and long-term results.
Barlow's disease remains a challenging surgical pathology in patients presenting with mitral regurgitation. We reviewed our early and long-term results for patients with Barlow's disease who underwent minimally invasive mitral valve surgery. ⋯ A wide variety of repair techniques can be used to perform successful minimally invasive mitral valve repair in the majority of patients with Barlow's disease, with good early and long-term results.