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Outcomes of surgical aortic valve replacement in moderate risk patients: Implications for determination of equipoise in the transcatheter era
Objective: To determine the contemporary outcomes of surgical aortic valve replacement (SAVR) in a moderate surgical risk population.Methods: We studied 502 consecutive adults who had undergone isolated SAVR from January 2002 to June 2011 for severe aortic valve stenosis with a Society of Thoracic Surgery predicted risk of mortality of 4% to 8%. We included concomitant coronary artery bypass and aortic annular enlargement but not other concomitant procedures. The updated Valve Academic Research Consortium definitions were used, as appropriate.Results: The median age was 80 years (range, 49-96), 323 (64.3%) had New York Hea...
Source: The Journal of Thoracic and Cardiovascular Surgery - October 7, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Sebastian A. Iturra, Rakesh M. Suri, Kevin L. Greason, John M. Stulak, Harold M. Burkhart, Joseph A. Dearani, Hartzell V. Schaff Tags: Acquired Cardiovascular Disease Source Type: research

Endovascular versus open elephant trunk completion for extensive aortic disease
Objectives: To compare the outcomes between patients undergoing endovascular (EEC) or open (OEC) approaches to second-stage elephant trunk completion (EC).Methods: From 1993 to 2010, 225 patients underwent second-stage EC (EEC, n = 92; OEC, n = 133). Propensity matching was performed for a fair comparison.Results: The EEC patients were older, more likely to have atrial fibrillation, and had a smaller proximal aorta. The 30-day mortality was 6.2% (6.5% EEC vs 6% OEC, P = .88). No difference was found in bleeding (8.8%), stroke (3%), renal failure (4%), or spinal cord injury (4%); however, the OEC patients required tra...
Source: The Journal of Thoracic and Cardiovascular Surgery - September 26, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Eric E. Roselli, Sreekumar Subramanian, Zhiyuan Sun, Jahanzaib Idrees, Edward Nowicki, Eugene H. Blackstone, Roy K. Greenberg, Lars G. Svensson, Bruce W. Lytle Tags: Acquired Cardiovascular Disease Source Type: research

Minimally invasive tricuspid valve surgery in patients at high risk
Conclusions: The heart-port–based minimally invasive approach seems to be safe, feasible, and reproducible in case of tricuspid valve operations. It ensures low perioperative morbidity, moderate to low rates of tricuspid regurgitation recurrence, and low late mortality. It also seems to have an added value in case of reoperative procedures.
Source: The Journal of Thoracic and Cardiovascular Surgery - April 29, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Davide Ricci, Massimo Boffini, Cristina Barbero, Suad El Qarra, Giovanni Marchetto, Mauro Rinaldi Tags: Acquired Cardiovascular Disease Source Type: research

Clinical outcomes of aortic root replacement after previous aortic root replacement
Conclusions: Aortic root replacement after a previous aortic root replacement is associated with a relatively low operative mortality and perioperative morbidity, but long-term survival is suboptimal. Increasing age and prosthetic valve endocarditis adversely affect survival.
Source: The Journal of Thoracic and Cardiovascular Surgery - August 22, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Luis Garrido-Olivares, Manjula Maganti, Susan Armstrong, Tirone E. David Tags: Acquired Cardiovascular Disease Source Type: research

Right anterior minithoracotomy versus conventional aortic valve replacement: A propensity score matched study
Conclusions: Right anterior minithoracotomy in patients undergoing isolated aortic valve surgery is associated with a lower incidence of postoperative atrial fibrillation and blood transfusion and shorter ventilation time and hospital length of stay. Prospective randomized trials are needed to confirm our data.
Source: The Journal of Thoracic and Cardiovascular Surgery - April 20, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Mattia Glauber, Antonio Miceli, Daniyar Gilmanov, Matteo Ferrarini, Stefano Bevilacqua, Pier A. Farneti, Marco Solinas Tags: Acquired Cardiovascular Disease Source Type: research

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