The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Rare Coronary Artery Variants are Associated with Increased Mortality and Reinterventions Following the Arterial Switch Operation.
To determine the influence of coronary anatomy on long-term outcomes of the arterial switch operation (ASO). ⋯ Rare coronary artery variants-particularly intramural-are associated with increased mortality and coronary reinterventions after ASO. A low threshold for unroofing intramurals is likely associated with declining mortality and improved outcomes. Additional investigations are needed to determine the long-term fate of the coronary arteries after ASO.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Valve Sparing Aortic Root Replacement: long-term variables significantly associated with mortality and morbidity.
In aortic root surgery, valve-sparing aortic root replacement is an attractive alternative by mitigating the risks inherent to prosthetic valves; however, little is known about the variables that impact its durability. We review our mid- to long-term outcomes after valve-sparing aortic root replacement and describe factors that impact survival and valve reintervention and insufficiency. ⋯ Valve-sparing aortic root replacement has excellent long-term outcomes, with low mortality and reintervention rates. Concomitant leaflet repair and bicuspid valve disease are the only long-term factors associated with reintervention.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Unplanned readmissions, community socioeconomic factors, and their effects on long-term survival after complex thoracic aortic surgery.
We evaluated community socioeconomic factors in patients who had unplanned readmission after undergoing proximal aortic surgery (ascending aorta, aortic root, or arch). ⋯ Among readmitted patients, Black patients and patients who had emergency surgery had less favorable community socioeconomic factors and poorer long-term survival. Earlier and more frequent follow-up in these patients should be considered. Developing off-campus clinics and specific postdischarge measures targeting these patients is important.