Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jan 2018
Acute DeBakey Type I aortic dissection without intimal tear in the arch: is total arch replacement the right choice?
Surgical management of acute DeBakey Type I aortic dissection without intimal tear in the aortic arch is controversial. This study compared short- and long-term outcomes of total arch replacement (TAR) versus limited ascending aorta/hemiarch replacement (no-TAR) in a consecutive series of patients. ⋯ TAR was associated with higher 30-day mortality compared with the less extensive hemiarch replacement. In the long term, TAR showed a trend of improved survival and higher reintervention rate.
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Interact Cardiovasc Thorac Surg · Jan 2018
Controlled flow diversion in hybrid venoarterial-venous extracorporeal membrane oxygenation.
Patients on venoarterial or venovenous extracorporeal membrane oxygenation (ECMO) support may require venoarterial-venous (VAV-ECMO) configuration during follow-up. We report 12 cases of VAV-ECMO with significant outflow steal. ⋯ Non-invasive monitoring of flow rates within the supplying cannulae of VAV-ECMO and the use of partial occlusion for venous-supplying cannula enable individualized patient management and effective weaning from VAV-ECMO.
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Interact Cardiovasc Thorac Surg · Jan 2018
Case ReportsPercutaneous left atrial unloading to prevent pulmonary oedema and to facilitate ventricular recovery under extracorporeal membrane oxygenation therapy.
Left-sided unloading during extracorporeal membrane oxygenation (ECMO) therapy is crucial to prevent pulmonary oedema and facilitate ventricular recovery. We present the case of a 55-year-old man under ECMO therapy with pre-existing left ventricular (LV) thrombus formation and in need of ventricular unloading. ⋯ Percutaneous trans-septal insertion of a TandemHeart cannula incorporated in an ECMO circuit for the prevention of pulmonary oedema and subsequent weaning from extracorporeal circulation was feasible and safe in a patient with cardiogenic shock and an LV thrombus.
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Interact Cardiovasc Thorac Surg · Jan 2018
Cold-inducible ribonucleic acid-binding protein attenuates acute kidney injuries after deep hypothermic circulatory arrest in rats.
Cold-inducible ribonucleic acid-binding protein (CIRP) has been identified to play a role in the antiapoptotic effect of hypothermia. We sought to investigate the renoprotection of CIRP in a rat model of deep hypothermic circulatory arrest. ⋯ Our findings suggest that the CIRP exerts a robust renoprotective effect by inhibiting apoptosis in the rat model of deep hypothermic circulatory arrest.