The Annals of thoracic surgery
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We investigated long-term outcomes of the distal false lumen of the aorta and aortic branches after distal anastomosis of the graft only to the true lumen in chronic type B aortic dissection. ⋯ In non-Marfan patients with chronic type B aortic dissection, the false lumen distal to the graft anastomosis was likely to be thrombosed when the graft was anastomosed to the true lumen only. Postoperative visceral circulation was not compromised, but spinal cord ischemia is a problem that remains to be solved.
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It is unclear whether right ventricular dysfunction after transplantation is due to donor brain death-related myocardial injury or recipient pulmonary hypertension. ⋯ Normal donor hearts adapt acutely to the recipient's elevated pulmonary vascular resistance by increasing right ventricular power output and contractility. Brain death caused significant right ventricular dysfunction and power loss, which further deteriorated after graft preservation and transplantation. The effects of donor brain death on myocardial function contribute to right ventricular dysfunction after cardiac transplantation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antegrade/retrograde cardioplegia for valve replacement: a prospective study.
From 1994 to 1996, 75 patients undergoing valve replacement were randomized to antegrade (36 patients, group 1) or antegrade/retrograde (39 patients, group 2) administration of cold blood cardioplegia. ⋯ Our study shows no significant advantage of the antegrade/retrograde administration of cardioplegia over the antegrade route in routine valvular replacement, other than a slightly shorter aortic cross-clamping time.
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Randomized Controlled Trial Comparative Study Clinical Trial
IL-6 and IL-8 levels after cardiopulmonary bypass are not affected by surface coating.
BACKGROUND.:Contact of blood with the surfaces of the cardiopulmonary bypass (CPB) circuit has been implicated as a cause of the inflammatory response. We undertook a prospective randomized trial of 200 pediatric patients, all with a calculated total bypass flow of less than 2.3 L/min (< 0.96 L/m2/min). ⋯ Albumin preprime and heparin-bonding do not attenuate the inflammatory response component attributable to the concentration of these markers.
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Randomized Controlled Trial Clinical Trial
Inhibitory effect of milrinone on cytokine production after cardiopulmonary bypass.
It has been suggested that cyclic adenosine monophosphate-elevating agents suppress cytokine production. To evaluate the effects of milrinone, a phosphodiesterase III inhibitor, on cytokine production after cardiopulmonary bypass, we conducted a prospective randomized study. ⋯ The results indicate that milrinone suppresses cytokine production by elevating cyclic adenosine monophosphate levels in patients undergoing cardiopulmonary bypass. With its positive inotropic and vasodilator activities, milrinone may have antiinflammatory effects.