Dugganpowell6432

With regards to age, operative mortality in patients aged 80 years or older was significantly higher than in those under 80 years of age for all surgical procedures in the root-ascending, arch, and descending regions.

Thoracic and thoracoabdominal aortic surgery in Japan was most commonly performed in elderly patients in their 70s, with a good overall mortality rate of 5.3%. Mortality and postoperative morbidity rates in patients aged 80 years or older were still high. In the future, further improvements in surgical outcomes are needed.

Thoracic and thoracoabdominal aortic surgery in Japan was most commonly performed in elderly patients in their 70s, with a good overall mortality rate of 5.3%. www.selleckchem.com/Androgen-Receptor.html Mortality and postoperative morbidity rates in patients aged 80 years or older were still high. In the future, further improvements in surgical outcomes are needed.

Endomyocardial biopsy is the gold standard and has a definite role in the surveillance of cardiac allograft rejection. Its role in other cardiac diseases is limited. However, it is required for conclusive diagnosis of a few entities in which it can influence patient management. There is no reported data regarding the utility of endomyocardial biopsy in the Indian population. Thus, this study was undertaken in a tertiary care center in India to assess the utility of endomyocardial biopsy in various cardiac diseases in the context of clinical diagnoses.

All endomyocardial biopsies conducted over a 27-year period were evaluated. Clinical details including indication for biopsy were collected. Histopathological findings were recorded and classified as definitive diagnosis, probable diagnosis with features consistent with the clinical diagnosis, and nonspecific morphological findings.

A total of 927 endomyocardial biopsies from 719 patients were reviewed. Endomyocardial biopsy was diagnostic in 12.5% of native cardiac biopsies and 52.1% showed nondiagnostic findings. The most frequent diagnoses were amyloidosis (58.7%) and myocarditis (8.6%). Endomyocardial biopsy had a diagnostic role in evaluation of restrictive cardiac diseases. Endomyocardial fibrosis and tubercular myocarditis, relatively more prevalent in the Indian population, were also identified. Cases of rheumatic heart disease, desmin cardiomyopathy, and microfibrillar cardiomyopathy were surprise findings, proving the usefulness of endomyocardial biopsy in detecting some rare cardiac conditions.

Endomyocardial biopsy is an important tool for the diagnosis of specific cardiac diseases including some rare entities, and for conditions which are more prevalent in our country, requiring biopsy confirmation.

Endomyocardial biopsy is an important tool for the diagnosis of specific cardiac diseases including some rare entities, and for conditions which are more prevalent in our country, requiring biopsy confirmation.

Effective treatment of patients with ischemic cardiomyopathy is one of the most difficult issues in contemporary cardiac surgery. The aim of this study was to evaluate the long-term effectiveness of reconstructive interventions on the left ventricle during chronic heart failure in patients with ischemic cardiomyopathy.

Between March 2013 and December 2017, 178 patients underwent surgical treatment for ischemic cardiomyopathy. Isolated coronary artery bypass grafting was compared with coronary artery bypass grafting with left ventricular reconstruction, using propensity score matching analysis. The primary endpoints of the study were hospital mortality and long-term survival.

After propensity score matching, 29 pairs of patients were compared. The 30-day hospital mortality was comparable (6.8% versus 6.8%,

 = 0.952), the average follow-up was 37.4 ± 12.6 months, with no statistically significant difference in mortality from all causes (

 = 0.352). After coronary artery bypass in combination with left ventricular reconstruction, patients showed a statistically significant decrease in clinical and functional indicators of chronic heart failure compared to those who had coronary artery bypass grafting alone, in terms of peak oxygen consumption (15.3 versus 13.5 mL·kg

·min

,

 = 0.043) and N-terminal pro-brain natriuretic peptide concentrations (298.6 versus 461.1 pg·mL

,

 = 0.032).

Compared to isolated coronary artery bypass, coronary artery bypass in combination with left ventricular reconstruction for the treatment of ischemic cardiomyopathy leads to a significant decrease in the clinical and functional parameters of chronic heart failure in the long-term postoperative period.

Compared to isolated coronary artery bypass, coronary artery bypass in combination with left ventricular reconstruction for the treatment of ischemic cardiomyopathy leads to a significant decrease in the clinical and functional parameters of chronic heart failure in the long-term postoperative period.Background In patients with obstructive hypertrophic cardiomyopathy, surgical myectomy (SM) is indicated for severe symptoms. We sought to compare long-term outcomes of patients with obstructive hypertrophic cardiomyopathy where SM was based on guideline-recommended Class I indication (Functional Class or FC ≥3 or angina/exertional syncope despite maximal medical therapy) versus earlier (FC 2 and/or impaired exercise capacity on exercise echocardiography with severe obstruction). Methods and Results We studied 2268 consecutive patients (excluding less then 18 years, ≥ moderate aortic stenosis and subaortic membrane, 56±14 years, 55% men), who underwent SM at our center between June 2002 and March 2018. Clinical data, including left ventricular outflow tract gradient, were recorded. Death and/or appropriate internal defibrillator discharge were primary composite end points. One thousand three hundred eighteen (58%) patients met Class I indication and 950 (42%) underwent earlier surgery; 222 (10%) had a history of obstructive coronary artery disease. Basal septal thickness, and resting and maximal left ventricular outflow tract gradient were 2.0±0.3 cm, 61±44 mm Hg, and 100±31 mm Hg, respectively. At 6.2±4 years after SM, 248 (11%) had composite events (13 [0.6%] in-hospital deaths). Age (hazard ratio [HR], 1.61; 95% CI, 1.26-1.91), obstructive coronary artery disease (HR, 1.46; 95% CI, 1.06-1.91), and Class I versus earlier SM (HR, 1.61; 95% CI, 1.14-2.12) were associated with higher primary composite events (all P less then 0.001). Earlier surgery had better longer-term survival (similar to age-sex-matched normal population) versus surgery for Class I indication (76 [8%] versus 193 [15%], P less then 0.001). Conclusions In patients with obstructive hypertrophic cardiomyopathy, earlier versus surgery for Class I indication had a better long-term survival, similar to the age-sex-matched US population.