Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2017
Hyperkalemic arrest and the aortic no-touch technique in minimally invasive atrial septal defect closure in adults.
To avoid aortic cross-clamping and cardioplegic ischaemia, we propose the induction of hyperkalemic arrest and using aortic no-touch technique in minimally invasive atrial septal defect (ASD) closure. Twenty-eight patients were included in this study. After establishment of cardiopulmonary bypass, potassium was administered to induce hyperkalemic arrest. ⋯ At the end of the operation, serum potassium was normalized to 4.1 ± 0.5 mEq/l. The mean arrest time was 11 ± 4.4 min without complications. Hyperkalemic arrest in combination with aortic no-touch technique is safe and efficacious in minimally invasive ASD closure.
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Interact Cardiovasc Thorac Surg · May 2017
Caveolin 2: a facultative marker of unfavourable prognosis in long-term patency rate of internal thoracic artery grafts used in coronary artery bypass grafting. Preliminary report.
Intimal hyperplasia leading to graft failure in patients undergoing coronary artery bypass grafting (CABG) is related to vascular smooth muscle cells (SMCs) proliferation. SMCs respond to a variety of mediators, the most important of which is platelet-derived growth factor (PDGF). The platelet-derived growth factor-induced cellular response has been shown to be mediated by caveolins. The aim of this study was to analyze CAV1-3 expression in internal thoracic artery (ITA) grafts used in CABG and correlate their expression with graft occlusion. ⋯ CAV2 expression in SMCs of the tunica media in autologous ITA transplants might indicate the risk of graft failure.
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Interact Cardiovasc Thorac Surg · May 2017
Perioperative outcomes of off-pump minimally invasive coronary artery bypass grafting with bilateral internal thoracic arteries under direct vision†.
We previously introduced techniques to harvest and use the right internal thoracic artery in minimally invasive coronary artery bypass grafting (CABG) via a single left thoracotomy for revascularization with bilateral internal thoracic arteries (BITA). We report our short-term outcomes of patients who underwent minimally invasive CABG using BITA and a single internal thoracic artery (SITA). ⋯ BITA can be safely harvested in a reproducible manner under direct vision via a small left thoracotomy. The potential advantages of minimally invasive CABG using BITA, although yet to be established, include a long-term survival benefit conferred by BITA grafts and elimination of the risk of sternal wound infection, in addition to the established advantages of minimally invasive coronary artery surgery. This approach has the potential for further optimization with hybrid revascularization strategies.