The Annals of thoracic surgery
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Review Meta Analysis
In search of the ideal pulmonary blood source for the Norwood procedure: a meta-analysis and systematic review.
A clear consensus regarding the optimal source of pulmonary blood flow in patients with hypoplastic left heart syndrome undergoing the Norwood procedure is lacking. ⋯ Our pooled analysis demonstrated no survival benefit for the MBTS or RV-PAS in patients undergoing the Norwood procedure. There appears to be an advantage with the RV-PAS with regard to interstage mortality at the cost of an increased rate of shunt intervention.
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Randomized Controlled Trial Multicenter Study
Acute kidney injury after on-pump or off-pump coronary artery bypass grafting in elderly patients.
An exploratory analysis of the German Off Pump Coronary Artery Bypass Grafting in Elderly Patients (GOPCABE) trial was performed to investigate the effect of off-pump coronary artery bypass grafting (CABG) on kidney function after the operation. ⋯ AKI was common in elderly patients undergoing CABG, but deterioration of kidney function requiring renal replacement therapy was a rare event. Off-pump CABG was not associated with decreased rates or reduced severity of AKI in elderly patients.
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Randomized Controlled Trial
Cerebral blood flow velocity and neurodevelopmental outcome in infants undergoing surgery for congenital heart disease.
Cerebral blood flow velocity (CBFV) measured by transcranial Doppler sonography has provided information on cerebral perfusion in patients undergoing infant heart surgery, but no studies have reported a relationship to early postoperative and long-term neurodevelopmental outcomes. ⋯ Postoperative CBFV after biventricular repair is related to early postoperative and neurodevelopmental outcomes at 1 year of age, possibly indicating that low CBFV is a marker of suboptimal postoperative hemodynamics and cerebral perfusion.
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Comparative Study
Thoracoscopic approach to lobectomy for lung cancer does not compromise oncologic efficacy.
We compared survival between video-assisted thoracoscopic surgery (VATS) and thoracotomy approaches to lobectomy for non-small cell lung cancer. ⋯ The thoracoscopic approach to lobectomy for non-small cell lung cancer does not result in worse long-term survival compared with thoracotomy.
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Optimal perfusion strategies for neuroprotection during infant cardiac surgery remain undefined. Despite encouraging experimental data, neurodevelopmental (ND) outcomes after cardiac surgery in neonates and infants using deep hypothermic circulatory arrest (DHCA) with a period of intermittent perfusion have not been reported, and it is not known whether DHCA can be extended while preserving ND outcomes. ⋯ Despite extended duration of total DHCA, the use of a period of intermittent perfusion to limit uninterrupted DHCA periods to less than 45 minutes could lead to ND outcomes similar to those of patients exposed to brief periods of DHCA. Deep hypothermic circulatory arrest with intermittent perfusion may facilitate implementation of prospective studies to identify the optimal cerebral perfusion strategy.