European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jun 2001
Cyclosporine A as a potential neuroprotective agent: a study of prolonged hypothermic circulatory arrest in a chronic porcine model.
To assess whether Cyclosporine A (CsA) or cycloheximide (CHX) can reduce ischemia-induced neurological damage by blocking apoptotic pathways, we assessed their effects on cerebral recovery in a chronic animal model of hypothermic circulatory arrest (HCA). ⋯ The data indicate that treatment with Cyclosporine A but not cycloheximide has a positive effect on cerebral recovery following HCA. Whether CsA results in inhibition of neuronal apoptosis, and/or inhibits release of cytokines and thereby reduces postischemic cerebral edema remains to be elucidated. The neuroprotective effect of CsA, if confirmed in further studies, would make its clinical application conceivable.
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Eur J Cardiothorac Surg · Jun 2001
Pulmonary thromboendarterectomy--risk factors for early survival and hemodynamic improvement.
Pulmonary thromboendarterectomy (PTE) for chronic thromboembolic pulmonary hypertension is a challenging procedure with a considerable mortality. The aim of this investigation was to identify risk factors influencing mortality and operative results. ⋯ Preoperative parameters can be utilized to assess postoperative mortality and hemodynamic improvement after pulmonary thromboendarterectomy. Patient age and clinical deterioration of pulmonary hypertension are considerable preoperative factors influencing hospital mortality. Inadequate postoperative hemodynamic improvement is affected by severity of disease and female sex.
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Eur J Cardiothorac Surg · Jun 2001
Randomized Controlled Trial Comparative Study Clinical TrialHeart-type fatty acid binding protein (hFABP) in the diagnosis of myocardial damage in coronary artery bypass grafting.
Heart-type fatty acid binding protein (hFABP) is an intracellular molecule engaged in the transport of fatty acids through myocardial cytoplasm and has been used as a rapid marker of myocardial infarction. However, its value in the evaluation of perioperative myocardial injury has not yet been assessed. ⋯ hFABP is a rapid marker of perioperative myocardial damage and peaks earlier than CKMB or TnI. The kinetics of marker proteins in serial samples immediately after reperfusion is more suitable for the detection of perioperative myocardial infarction than a fixed cut-off level.
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Eur J Cardiothorac Surg · Jun 2001
Comparative StudyApoptotic cell death in the hippocampus due to prolonged hypothermic circulatory arrest: comparison of cyclosporine A and cycloheximide on neuron survival.
To determine whether cyclosporine A (CsA) or cycloheximide (CHX) can reduce neuronal apoptosis in the hippocampus in a chronic animal model of hypothermic circulatory arrest (HCA). ⋯ The data clearly demonstrate apoptotic cell death in pigs after HCA by simultaneously demonstrating in situ end labeling (TUNEL reaction) and apoptotic chromatin condensation using a nucleic acid-binding dye. Since CsA shows promising neuroprotective effects in behavioral studies, and since the peak of HCA-induced apoptosis occurs earlier than 7 days, further studies will be required to determine whether CsA can improve neuronal survival in the first few days after HCA. CHX was not effective in reducing apoptosis in this model.
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Eur J Cardiothorac Surg · Jun 2001
Comparative StudyTracheal surgery in children: an 18-year review of four techniques.
Review the short- and long-term outcomes of a single institution experience in infants with congenital tracheal stenosis, comparing four different operative techniques used from 1982 through 2000. ⋯ Our current procedures of choice for infants with congenital tracheal stenosis are resection with end-to-end anastomosis for short-segment stenoses (up to eight rings) and the autograft technique for long-segment stenoses. Associated pulmonary artery sling and intracardiac anomalies should be repaired simultaneously.