European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Oct 2006
Comparative StudyComparative study of donor lung injury in heart-beating versus non-heart-beating donors.
The use of non-heart-beating donors (NHBD) has been advocated as an alternative to overcome the critical organ shortage in lung transplantation despite the warm ischemic period that may result in primary graft dysfunction. On the contrary, brain death in the heart-beating donor (HBD) may be an underestimated risk factor for donor lung injury. We postulated that 60 min of warm ischemia in the NHBD is less detrimental to the lung than the pathophysiological changes after brain death in the HBD. In this study we compared the quality of lungs from HBD versus NHBD in an isolated reperfusion model. ⋯ These data indicate that 1-h warm ischemic lungs in our model are less susceptible to ischemia-reperfusion injury than lungs retrieved 5 h after brain death. This study further supports the use of lungs from NHBD for pulmonary transplantation.
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Eur J Cardiothorac Surg · Oct 2006
A single 24F Blake drain after wedge resection or lobectomy: a study on 100 consecutive cases.
To evaluate the results of chest drainage using one 24F Blake drain after standard thoracic operations (wedge resection and lobectomy). ⋯ Postoperative courses after standard thoracic procedures using a single 24F Blake drainage appear similar to that accounting after a classical semi-rigid drainage. Such single drainage may appear now as an acceptable option. The flexible quality of the drain, its reduced caliber, and the character unique of the drainage, may contribute to improve comfort of the operated patients.
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Eur J Cardiothorac Surg · Oct 2006
Randomized Controlled TrialThe role of leukocyte depleting filters in heart transplantation: early outcomes in prospective, randomized clinical trial.
Leukocyte-mediated reperfusion injury to cardiac allograft in the perioperative period is most likely associated with the early and late mortality after heart transplantation (Htx). Our aim is to determine the efficacy and safety of using leukocyte-depleting filters in a cardiopulmonary bypass (CPB) and secondary blood cardioplegia (SBC) circuit in Htx. ⋯ The use of leukocyte depleting filters in heart transplantation is an effective, easy and safe method of myocardial protection, reducing significant myocardial reperfusion injury and improving posttransplant graft functional recovery.
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Eur J Cardiothorac Surg · Oct 2006
Multicenter Study Comparative StudyPredicted versus observed FEV1 in the immediate postoperative period after pulmonary lobectomy.
Scanty information can be found regarding ppoFEV1% correlation with true FEV1% in the immediate days after surgery, when most cardio-respiratory complications are developed. This prospective multicentric investigation aims to describe the evolution of FEV1 in a series of uneventful lobectomy cases before hospital discharge, and to identify factors associated with the variation of postoperative residual FEV1, with the ratio between the actual and the predicted postoperative FEV1 measured during the first 6 postoperative days. ⋯ Current methods of prediction of postoperative FEV1 greatly underestimated the real functional loss in the immediate postoperative period. Therefore, for the purpose of a more accurate risk stratification we need to correct the traditional prediction of postoperative FEV1.
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Eur J Cardiothorac Surg · Oct 2006
Randomized Controlled Trial Comparative StudyEvaluation of myocardial metabolism with microdialysis during bypass surgery with cold blood- or Calafiore cardioplegia.
For the first time, microdialysis was used to investigate in vivo and online the myocardial metabolism during and after cardiac surgery in patients treated with two different methods of myocardial protection. ⋯ The oxidative stress measured was significantly higher in patients undergoing CABG using modified Calafiore cardioplegia, whereas the cold cardioplegia minimised the effects of aortic clamping. The results indicate that cold cardioplegia offers superior protection of the heart, in terms of more rapid normalisation of myocardial metabolism. In elective myocardial revascularisation, intermittent antegrade warm blood cardioplegia is a comparable safe method of myocardial protection. However, in patients referring to a long clamping time, advantages of cold cardioplegia for myocardial revascularisation may be magnified.