European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2004
Repair of the descending thoracic aorta: impact of open distal anastomosis technique on spinal cord perfusion, neurological outcome and spinal cord histopathology.
We investigated the impact of equilibrating distal aortic pressure with atmospheric pressure (open distal anastomosis) on spinal cord perfusion, neurological outcome and spinal cord histopathology in a rat model of descending thoracic aortic surgery. ⋯ Equilibrating distal arterial pressure with atmospheric pressure during thoracic aortic occlusion decreased spinal cord blood flow, increased mortality and worsened spinal cord injury in rats. These results suggest that the open distal anastomosis technique should be used with caution in patients undergoing repair of the descending thoracic or thoracoabdominal aorta.
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Eur J Cardiothorac Surg · Aug 2004
Randomized Controlled Trial Clinical TrialProphylactic tranexamic acid in elective, primary coronary artery bypass surgery using cardiopulmonary bypass.
Perioperative use of tranexamic acid (TA), a synthetic antifibrinolytic drug, decreases perioperative blood loss, and the proportion of patients receiving blood transfusion in cardiac surgery, but the results may vary in different clinical settings. The primary objective of the present study was to determine the efficacy of TA to decrease chest tube drainage and the proportion of patients requiring perioperative allogeneic transfusions following primary, elective, on-pump coronary artery bypass grafting (CABG) in patients with a low baseline risk of postoperative bleeding. ⋯ An antifibrinolytic effect following prophylactic use of TA in elective, primary CABG among patients with a low risk of postoperative bleeding, did not result in any significant decrease in postoperative bleeding compared to a placebo group.
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Eur J Cardiothorac Surg · Aug 2004
Changes in coagulation condition, cytokine, adhesion molecule after repair of type A aortic dissection.
Because residual dissection often exists even after the repair of a type A dissection, we evaluated coagulation conditions, cytokine levels, and adhesion molecule levels in mid-term follow up after repair of type A dissections. ⋯ Hypercoagulation conditions continued even after repair. Both TAT and D-dimer would be good indices for following up patients having repaired aortic dissections. Furthermore, cytokine, adhesion molecules, and collagen turnover would return to a stable state unless impairment and expansion of the vessel wall occurred.
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Eur J Cardiothorac Surg · Aug 2004
A new computer model of mitral valve hemodynamics during ventricular filling.
Quantitative description of left ventricular diastolic filling and mitral valve function remains difficult despite advances in echocardiography. The purpose of the present study was to develop a lumped parameter model of left ventricular filling and validate it in porcine trials under physiological conditions and after valve replacement. ⋯ The new lumped parameter model of left ventricular filling allows for the first time a detailed simulation of pressure and flow curves in the left heart including transmitral hemodynamics.
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Eur J Cardiothorac Surg · Aug 2004
Comparative analysis of T2 selective division of rami-communicantes (ramicotomy) with T2 sympathetic clipping in the treatment of craniofacial hyperhidrosis.
The main cause of dissatisfaction after sympathetic trunk blocking surgery (T2 sympathectomy, sympathetic clipping) for craniofacial hyperhidrosis is compensatory sweating. Preserving sympathetic trunk may decrease the incidence of compensatory sweating, and we introduce T2 ramicotomy, which may better preserve the sympathetic nerve trunk in order to reduce compensatory sweating. ⋯ T2 ramicotomy for craniofacial hyperhidrosis lowers the rate of compensatory sweating and excessive dryness of face compared to T2 clipping.