The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Jun 2006
Comparative StudyClinical impact of interstitial pneumonia following surgery for lung cancer.
Operative morbidity in patients with lung cancer associated with perioperative interstitial pneumonia (IP) has emerged as a serious problem. ⋯ Postoperative development IP is a serious complication with high mortality, and serial measurement of KL-6 levels is useful to assess the activity of IP.
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Thorac Cardiovasc Surg · Jun 2006
Comparative StudyC1-INH and its effect on infarct size and ventricular function in an acute pig model of infarction, cardiopulmonary bypass, and reperfusion.
Recent studies suggest that complement inhibition reduces reperfusion injury. A clinical setting with local application of a C1 esterase inhibitor (C1-INH) has been modeled in an animal study in order to further investigate these findings. ⋯ Intracoronary application of complement inhibitor in an acute infarction model, which mimicked a clinical setting of urgent coronary bypass grafting after ischemia, has been shown to neither influence the area of infarction, nor the ventricular function.
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Thorac Cardiovasc Surg · Jun 2006
Case ReportsRecovery from giant cell myocarditis with ECMO support and utilisation of polyclonal antithymocyte globulin: a case report.
Giant cell myocarditis (GCM) is a rare and frequently fatal disorder. Patients suffer of ventricular arrhythmias or congestive heart failure. ⋯ The novel utilisation of ECMO in GCM related cardiogenic shock and application of rATG have prooven life-saving in this patient. Studies utilizing rATG in the treatment of GCM are warrented.
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Thorac Cardiovasc Surg · Jun 2006
Case ReportsSurgical repair of the aortic coarctation combined with complete replacement of the ascending aorta and aortic arch.
We present a 63-year-old patient with aortic valve stenosis, ascending aorta aneurysm, aortic coarctation as well as atherosclerotic, elongated, and stenosed aortic arch. Surgical treatment consisted of a complete ascending aorta replacement with a valved composite graft and complete replacement of the aortic arch including the isthmus, and was performed simultaneously through median sternotomy.
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Thorac Cardiovasc Surg · Apr 2006
Comparative StudyTirofiban (Aggrastat) protects platelets and decreases platelet-granulocyte binding in an extracorporeal circulation model.
Extracorporeal circulation (ECC) induces platelet activation and inflammation with potentially life-threatening organ dysfunction. Short-acting GP IIb/IIIa inhibitors like tirofiban and eptifibatide protect platelets during ECC without increasing bleeding complications and may reduce inflammation. This study investigates anti-thrombotic and anti-inflammatory effects of different platelet inhibitors. ⋯ Amongst the investigated drugs only GP IIb/IIIa inhibitors decreased activation, aggregation, and loss of platelets during ECC but acted differently on platelet-granulocyte interaction. A short-acting GP IIb/IIIa inhibitor with the potential to inhibit platelet activation and platelet-leukocyte interaction should be considered both for platelet protection and inhibition of platelet-mediated inflammation during ECC.