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Journal and News Scan
An interesting case series of cardiotoxicity of modern chemotherapy attempting to elucidate mechanisms of heart failure. This pilot study could well lead to further investigation of finite pathways related to surgical aspects of transplanation, anti-rejection therapy in particular: The authors propose that the immune system is a mediator of cardiac dusfunction.
This single institution study evalated the effect of prosthesis choice on regression of LV mass after AVR in patients with AS. The St. Jude Trifecta performed better than the Edwards Perimount Magna Ease in terms of LV mass regression and intermediate-term clinical outcomes such as valve gradients, freedom from readmission, and all-cause mortality.
The authors examined the concordance of clinical and pathological staging using prospectively collected data from the Dutch Lung Surgery Audit, examining patients with clinical stage I disease. Among 1,555 patients, the concordance of cTNM and pTNM was 60%. 22.6% of patients were upstaged after resection, . The difference was more evident in patients with T2a tumors.
This database study evaluated outcomes of delayed sternal closure for infants undergoing surgery on cardiopulmonary bypass. Delayed closure was associated with a 3-fold increase in infectious complications. Time to closure was associated with an increasing rate of infectious complications. Location of closure (OR, ICU) was not associated with adverse outcomes.
This single institution study explored the frequency and time course of failure of mitral valve repair for MR caused by prolapse using longitudinal echocardiography. Recurrent MR developed in 49 (5.7%) patients at a mean of 3.1 years; 6 had prolapse and 43 did not. Severe MS occurred in 3. Reoperation was performed in 21 patients, and was most commonly valve replacement.
This single institution retrospective study evaluated outcomes of valve replacement for degenerated bioprosthetic aortic valves comparing surgical AVR (SAVR) to transcatheter valve-in-valve procedures (TViV). Patients were matched into 2 groups of 22 according to STS risk scores. Operative mortality, stroke rate, and 3-year survival were similar between the groups.
This single center review assessed the need for reintervention after pulmonary valve replacement with bioprostheses for congenital heart disease. Most patients had TOF, and most were in their teens or twenties. After correction for age, the Sorin Mitroflow valve required reintervention sooner and more often than the other two valves (Carpentier-Edwards Magna and MagnaEase, Carpentier-Edwards Perimount). Valve type was the only independent predictor of reintervention.
This retrospective single institution report examined outcomes of repair of large airway defects with bioprothetic materials. 8 patients underwent repair with aortic homograft or acellular dermal matrix, 5 of whom suffered from airway-enteric fistulae. Most repairs were buttressed with muscle or omentum. All airways healed; 2 required debridement of granulation tissue and 1 required dilation.
One-hundred eleven patients who underwent surgical repair of acute type A aortic dissection without preoperative malperfusion are analyzed for outcome with regard to arterial cannulation site, route of cerebral perfusion and surgeon’s specific experience. Potential biases are discussed.
The retrospective study includes 434 patients with total cavopulmonary connection. Clinical results and factors influencing the outcome are analyzed.