The Annals of thoracic surgery
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Numerous gaseous microemboli (GME) are delivered into the arterial circulation during cardiopulmonary bypass (CPB). These emboli damage end organs through multiple mechanisms that are thought to contribute to neurocognitive deficits after cardiac surgery. Here, we use hypobaric oxygenation to reduce dissolved gases in blood and greatly reduce GME delivery during CPB. ⋯ Hypobaric oxygenation is an effective, low-cost, common sense approach that capitalizes on the simple physical makeup of GME to achieve their near-total elimination during CPB. This technique holds great potential for limiting end-organ damage and improving outcomes in a variety of patients undergoing extracorporeal circulation.
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Case Reports
Innominate pseudoaneurysm subtotally compressing the trachea as a result of blunt trauma.
Blunt traumatic innominate pseudoaneurysm is rare, and coexisting airway distress is even rarer. We describe a case of innominate pseudoaneurysm that subtotally compressed the trachea in a 45-year-old man. The patient also had bovine-type arch anatomy. ⋯ The pseudoaneurysm was eliminated and airway compression was completely relieved. The patient fully recovered without major complications. The unique feature of this case is its association with airway compression, which is uncommon but potentially lethal.
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This study is a single-center experience with surgical repair of anomalous origin of left coronary artery from pulmonary artery (ALCAPA) with focus on the management of associated mitral regurgitation (MR). ⋯ Surgical repair of ALCAPA has good long-term results with low mortality and reintervention rates. The majority of MR is functional and will improve with reperfusion, but structural mitral valve abnormalities should be repaired at the time of surgery.
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Biography Historical Article
Herbert Sloan, MD, October 10, 1914 - May 17, 2013.
Dr Herbert Sloan was the 10th president of The Society of Thoracic Surgeons and served for 15 years as the second editor of The Annals of Thoracic Surgery. One of few thoracic surgeons to lead both organizations, he also served as the 60th president of the American Association for Thoracic Surgery. Deeply committed to the mission of the American Board of Thoracic Surgery to maintain the highest standards for our specialty, he served on the American Board of Thoracic Surgery for 20 years, 13 as its secretary-treasurer. He left a legacy of thoracic surgery resident education as head of the Section of Thoracic Surgery at the University of Michigan.