European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2009
Valve-sparing aortic root remodeling with partial preservation of the intact native aortic sinuses.
There are certain aortic root pathologies where only one or two of the aortic sinuses are diseased. We aimed to evaluate our mid-term results after a partial remodeling of the aortic root. A total of 220 patients underwent a valve-sparing operation at our institution. ⋯ Longitudinal analysis revealed no development of clinically significant aortic regurgitation (<0.03 grades per year). However, in contrast to the group that underwent complete remodeling (n=108), a significant dilatation at sinus and ST junction (STJ) level could be observed in the partial remodeling group over time (0.35 and 0.48 mm per year, respectively). This should be taken into consideration when applying this technique in patients operated on an elective basis.
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Eur J Cardiothorac Surg · Sep 2009
Brain preservation with selective cerebral perfusion for operations requiring circulatory arrest: protection at 25 degrees C is similar to 18 degrees C with shorter operating times.
Hypothermic circulatory arrest (HCA) is employed for aortic arch and other complex operations, often with selective cerebral perfusion (SCP). Our previous work has demonstrated real-time evidence of improved brain protection using SCP at 18 degrees C. The purpose of this study was to evaluate the utility of SCP at warmer temperatures (25 degrees C) and its impact on operating times. ⋯ HCA results in cerebral hypoxia, energy depletion and ischaemic injury, which are attenuated with the use of SCP at both 18 degrees C and 25 degrees C. Procedures performed at 25 degrees C had significantly shorter operating times while preserving end organs.