The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2009
Randomized Controlled Trial Comparative StudyMyocardial revascularization with miniaturized extracorporeal circulation versus off pump: Evaluation of systemic and myocardial inflammatory response in a prospective randomized study.
This prospective randomized study sought to verify the systemic inflammatory response, inflammatory myocardial damage, and early clinical outcome in coronary surgery with the miniaturized extracorporeal circulation system or on the beating heart. ⋯ Miniaturized extracorporeal circulation can be considered similar to off-pump surgery in terms of systemic inflammatory response, myocardial inflammation and damage, and early outcome.
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J. Thorac. Cardiovasc. Surg. · May 2009
Comparative StudyValve-sparing and valve-replacing techniques for aortic root replacement in patients with Marfan syndrome: Analysis of early outcome.
A prospective, international registry study was initiated to provide contemporary comparative data on short-term clinical outcomes after aortic valve-sparing and aortic valve-replacing root operations in patients with Marfan syndrome. The purpose of this initial report is to describe the study design and to compare early outcomes in the first 151 enrolled patients. ⋯ The analysis of early outcomes revealed that valve-sparing techniques were the most common approach to root replacement in patients with Marfan syndrome in these centers. The complexity of valve-sparing root replacement did not translate into any demonstrable adverse early outcomes. Subsequent analysis will compare the 3-year durability of these two surgical approaches.
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J. Thorac. Cardiovasc. Surg. · May 2009
Factors associated with arch reintervention and growth of the aortic arch after coarctation repair in neonates weighing less than 2.5 kg.
Neonates weighing less than 2.5 kg with aortic coarctation are challenging. We sought to find the prevalence of death or aortic arch reintervention and their determinants after coarctation repair. We also sought to define growth trajectories for postrepair aortic arch dimensions and identify factors associated with accelerated longitudinal growth. ⋯ Mortality and arch reintervention are common after initial repair of coarctation of the aorta in neonates weighing less than 2.5 kg. Catch-up growth of both the transverse arch and isthmus occurs after coarctation repair, especially in those with the smallest arch parameters, and may be increased by using an extended end-to-end technique.
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J. Thorac. Cardiovasc. Surg. · May 2009
Comparative StudyShort- and midterm outcomes of coronary artery bypass surgery performed by surgeons in training.
The effect of training on outcomes in cardiac surgery is poorly studied. We aimed to study the results of coronary artery bypass grafting procedures performed by surgeons in training across our state with respect to short- and midterm postoperative outcomes. ⋯ Coronary artery bypass grafting performed by trainee surgeons within a supervised program is safe with acceptable short- and midterm outcomes.
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J. Thorac. Cardiovasc. Surg. · May 2009
Regional wall motion abnormalities and scarring in severe functional ischemic mitral regurgitation: A pilot cardiovascular magnetic resonance imaging study.
To relate cardiovascular magnetic resonance-derived segmental wall motion and myocardial scarring and determine whether they are associated with postoperative mitral regurgitation following coronary artery bypass grafting and annuloplasty for severe functional ischemic mitral regurgitation. ⋯ In a pilot study of cardiovascular magnetic resonance imaging in severe functional ischemic mitral regurgitation, severity of posterior papillary muscle region scarring correlated with decreased segmental wall motion and mitral regurgitation early after coronary revascularization and annuloplasty. Routinely assessing scar burden may identify patients for whom annuloplasty alone is insufficient to eliminate mitral regurgitation.