The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Late recovery of atrioventricular conduction after postsurgical chronic atrioventricular block is not exceptional.
Postsurgical atrioventricular block may complicate surgery for congenital heart defects and is generally considered permanent when persisting longer than 14 days after surgery. In this study, we evaluate the occurrence of spontaneous late recovery of atrioventricular conduction in postsurgical chronic atrioventricular block and discuss its clinical implications. ⋯ Complete recovery of atrioventricular conduction or regression to asymptomatic first-degree atrioventricular block occurred in 12% of patients with postsurgical chronic second- or third-degree atrioventricular block. To prevent unnecessary adverse side effects of chronic ventricular pacing and to prolong battery longevity, ventricular pacing should be minimized in patients with recovered normal atrioventricular conduction.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Predictors of hyperglycemia after cardiac surgery in nondiabetic patients.
Postoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing cardiac surgery. However, some experts consider hyperglycemia to be an epiphenomenon related to acute stress. We investigated whether preoperative patient characteristics can predict hyperglycemia after cardiac surgery in nondiabetic patients. ⋯ Preoperative patient characteristics are associated with hyperglycemia after cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Introducing transapical aortic valve implantation (part 1): effect of a structured training program on clinical outcome in a series of 500 procedures.
The purpose of the present study was to test whether the cumulative knowledge from the field of transapical transcatheter aortic valve implantation, when incorporated into a structured training and then gradually dispersed by internal proctoring, might eliminate the negative effect of the learning curve on the clinical outcomes. ⋯ The structured training program can be used to introduce transapical transcatheter aortic valve implantation and then gradually dispersed by internal proctoring to other members of the team with no concomitant detriment to patients.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Surgical outcomes after cardiac surgery in liver transplant recipients.
This was a single-center retrospective study to assess the surgical outcomes and predictors of mortality of liver transplant recipients undergoing cardiac surgery. ⋯ Cardiac surgery in the liver allograft recipients was associated with acceptable surgical outcomes. Preoperative encephalopathy and pulmonary hypertension were independent predictors of late mortality. The cutoff value of 13.5 in the MELD score might be useful for predicting surgical mortality in cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Clinical TrialClinical analysis of concomitant valve replacement and bipolar radiofrequency ablation in 191 patients.
The study objective was to evaluate the safety and efficacy of concomitant bipolar radiofrequency ablation and heart valve replacement in patients with rheumatic heart disease and atrial fibrillation. ⋯ Concomitant bipolar radiofrequency ablation is an effective and safe technique for treating atrial fibrillation in patients with rheumatic heart disease undergoing valve replacement, with promising follow-up results.