The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Early experience treating tricuspid valve endocarditis with a novel extracellular matrix cylinder reconstruction.
The short-term outcomes were evaluated in patients treated for tricuspid valve endocarditis using a novel extracellular matrix (ECM) cylinder reconstruction technique. ⋯ Cylinder reconstruction with ECM could be a suitable technique for replacing the tricuspid valve while preserving annuloventricular continuity in patients with infective endocarditis not repairable by conventional techniques.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Persistent fenestration may be a marker for physiologic intolerance after Fontan completion.
We sought to evaluate the medium-term implications of fenestration status. ⋯ Persistent fenestration was a marker for physiologic intolerance as noted by increased rates of mortality and a higher incidence of Fontan failure/complications. The specificity of pre-Fontan physiologic data for fenestration status may not have the fidelity needed for long-term care and thus, the consequences of decision making regarding fenestration status may not be determined until well after the operation.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Early and midterm outcomes of left pulmonary artery angioplasty using an anterior wall flap of the main pulmonary artery in tetralogy of Fallot repair.
Postoperative left pulmonary artery (LPA) kinking is problematic in repair of tetralogy of Fallot (TOF). We used angioplasty of the proximal LPA with an anterior wall flap of the main pulmonary artery (MPA) to prevent this problem. ⋯ Angioplasty of the proximal LPA using an anterior wall flap of the MPA in the patients with TOF and pulmonary stenosis is an effective method in the management of acute angle and/or stenosis of LPA without postoperative kinking.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Systolic anterior motion of the mitral valve: a 30-year perspective.
Systolic anterior motion (SAM) can occur after mitral valve repair (MVr), most frequently in patients with degenerative valve disease. Our initial observations (1981-1990) revealed that most patients with SAM can be successfully treated medically. Here the authors review the last 16 years of their experience with SAM after MVr. ⋯ In the more recent era, SAM occurs one-third less frequently after repair of degenerative mitral valve disease. Use of an incomplete annuloplasty band rather than a complete ring is associated with a lower incidence of SAM. The mainstay treatment of SAM continues to be medical management.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Observational StudyMinimally invasive right thoracotomy approach for mitral valve surgery in patients with previous sternotomy: a single institution experience with 173 patients.
This study presents a review of our experience with minimally invasive mitral valve surgery (MIMVS) in patients with a previous cardiac procedure performed through a sternotomy over a 10-year period. ⋯ Reoperative mitral valve surgery can be safely performed through a right minithoracotomy with good early and late outcomes. The avoidance of extensive surgical dissection, optimal valve exposure, and low blood transfusion are the main advantages of this technique.