Abstract:
:A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: What is the role of mechanical valve prostheses in pulmonary valve replacement late after tetralogy of Fallot (TOF) repair? Altogether more than 30 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. In addition to this, two papers were found by searching the reference lists of the relevant papers. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude from the best evidence available that mechanical prosthetic valves do play a role in patients who require pulmonary valve replacement late after repair of TOF. With adequate anticoagulation, they represent a safe alternative to biological valves. Although the literature is very limited, in terms of patient numbers, many of the papers demonstrate an acceptable early mortality rate. There is significant variability in the regimes of anticoagulation in these patients, and the overall reported rate of valvar thrombosis, thromboembolic events and major haemorrhagic complications has also been variable. The overall rate of valvar thrombosis and other thromboembolic events is promising. Thrombotic events were often attributed to poor adherence to the anticoagulation regime. Conversely, 3 papers recorded no thromboembolic events during the follow-up period. Three papers recorded major haemorrhagic events during their follow-up period and concluded that these were a rare outcome. When appropriate anticoagulation is adhered to, mechanical pulmonary prostheses appear to be relatively safe in patients late after repair of TOF. We have also found that the rationale for insertion of mechanical valves in the pulmonary position late after TOF repair varies across centres is still controversial. Furthermore, their use in patients with concomitant pulmonary arterial stenoses may be less advisable as this will prevent future percutaneous interventions of the pulmonary arterial tree. More research is required to accurately compare the haemodynamic properties of mechanical valves in the pulmonary position compared with other valves. Additionally, a more consistent follow-up of these patients in terms of echocardiographic, valve-related and warfarin-related complications is needed. With this information, clearer conclusions may be drawn when considering their role.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Abbas JR,Hoschtitzky JAdoi
10.1093/icvts/ivt541subject
Has Abstractpub_date
2014-05-01 00:00:00pages
661-6issue
5eissn
1569-9293issn
1569-9285pii
ivt541journal_volume
18pub_type
杂志文章,评审abstract:OBJECTIVES:Patients with pleural infections frequently have several comorbidities and inferior long-term survival. We hypothesized that these patients represent a vulnerable cohort with high rates of hospitalization and frequent use of healthcare services. This study aims to ascertain the need for and causes of treatme...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa147
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:Recent evidence shows that permissive anaemia strategies are safe in different surgical settings. However, effects of variations in haemoglobin (Hb) levels could have a negative impact in high-risk patients. We investigated the combined effect of postoperative Hb concentration and cardiac risk status on majo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz199
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abstract:OBJECTIVES:Primary adenosquamous carcinoma (ASC) of the lung is rare. The current study was a retrospective two-institutional analysis of surgical therapy with respect to the clinicopathological characteristics and prognostic factors associated with ASC of the lung. METHODS:The clinical records of patients with pathol...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
doi:10.1093/icvts/ivv369
更新日期:2016-04-01 00:00:00
abstract::Positron-emission tomography scans (PET) with fluorine-18-fluorodeoxyglucose ((18)F- FDG) are usually negative in leiomyomas. Two patients underwent a PET that showed an increased (18)F- FDG uptake of the distal oesophagus suggestive for malignancy. Both patients were operated on and histologic examination revealed a ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr037
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abstract::Transatrial cannulation of the left ventricle was introduced as a safe and easy cannulation method for antegrade arterial return in type A aortic dissection. However, because of the paucity of clinical reports, little is known about the complications or shortcomings of this technique. Herein, we report a case of pulmo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz190
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abstract:OBJECTIVES:The Synergy CircuLite micropump is a novel partial-support miniature left ventricular assist device that propels 2-3 l/min blood from the left atrium into the right subclavian artery. The ability of currently available investigative modalities to confirm Synergy pump malfunction is limited. The Synergy speed...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu236
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abstract:OBJECTIVES:Our goal was to evaluate the impact of the adult congenital heart disease anatomical and physiological (ACHD AP) classification system on the surgical management of Ebstein anomaly (EA) in adult patients. METHODS:From February 2000 through August 2017, data of patients aged at least 16 years, who underwent ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa294
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abstract:OBJECTIVES:The frozen elephant trunk technique is an increasingly common treatment for extensive disease of the thoracic aorta. The objective of the study was to evaluate the outcomes of frozen elephant trunk specifically in chronic (residual) aortic dissections, focusing on downstream aortic remodelling. METHODS:Betw...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa305
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journal_title:Interactive cardiovascular and thoracic surgery
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doi:10.1093/icvts/ivaa278
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00169-5
更新日期:2003-12-01 00:00:00
abstract::Five days following bilateral thoracoscopic lung volume reduction surgery for emphysema, a 63-year-old man underwent reoperation for closure of a massive bronchopleural fistula. It was discovered intraoperatively that the fistula was located distant from prior staple lines or resection sites from his surgery. This cas...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.197434
更新日期:2009-04-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.184200
更新日期:2009-02-01 00:00:00
abstract::Elevated plasma homocysteine (Hcy) is one of the suggested risk factors for endothelial dysfunction. There is evidence of association between raised plasma Hcy and an increased risk of developing peripheral arterial disease. A causal relationship, however, has not been established. In this report, a 37-year old male p...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt068
更新日期:2013-06-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt292
更新日期:2013-11-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.220335
更新日期:2010-05-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-05-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa298
更新日期:2020-12-13 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt411
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.268888
更新日期:2011-08-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr086
更新日期:2012-05-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.114678
更新日期:2006-04-01 00:00:00
abstract::Anomalous coronary arteries arising from the pulmonary trunk is a rare but potentially fatal condition. We report the clinical presentation, surgical treatment and long-term follow-up of seven surgical cases of anomalous left coronary and one case of anomalous right coronary artery arising from the pulmonary artery. A...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.184903
更新日期:2009-01-01 00:00:00
abstract::False aortic aneurysm is an uncommon complication after oesophageal perforation and results in a high rate of mortality. A 63-year-old patient presented with acute chest pain. Biochemical tests (cardiac enzymes) and electrocardiogram were normal. A thoracic and abdominal CT scan was performed, and showed a foreign bod...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs385
更新日期:2013-01-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy143
更新日期:2018-11-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.223776
更新日期:2010-04-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx325
更新日期:2018-03-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
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更新日期:2015-07-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
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更新日期:2016-01-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
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更新日期:2015-02-01 00:00:00