The Annals of thoracic surgery
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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.
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Cardiac operations frequently are complicated by postoperative cognitive decline. Less common and less studied is postoperative cognitive decline after noncardiac surgery, so we determined its incidence, severity, and possible predictors. ⋯ Cognitive decline after noncardiac operations is a frequent complication of surgical procedures. The severity could preclude successful return to a preoperative lifestyle.
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We treated two cases of enlargement of ulcer-like projections in the descending thoracic aorta, which were recognized after emergency graft replacement from the ascending aorta to the aortic arch for acute type A aortic dissection. The intimal tear, which was near the left subclavian artery, was resected during the initial operation. Graft replacement of the descending thoracic aorta was successful.