European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 2012
Tissue-engineered vascular graft remodeling in a growing lamb model: expression of matrix metalloproteinases.
We have previously demonstrated the functionality and growth of autologous, living, tissue-engineered vascular grafts (TEVGs) in long-term animal studies. These grafts showed substantial in vivo tissue remodeling and approximation to native arterial wall characteristics. Based on this, in vitro and in vivo matrix metalloproteinase (MMP) activity of TEVGs is investigated as a key marker of matrix remodeling. ⋯ MMPs are up-regulated in vitro by dynamic culture conditions and could contribute to increased matrix remodeling, native analogous tissue formation and functional growth of TEVGs in vivo. Monitoring of MMP activity, for example, by molecular imaging techniques, may enable the non-invasive assessment of functional tissue quality in future clinical tissue-engineering applications.
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Eur J Cardiothorac Surg · Jan 2012
Review Meta AnalysisEstimating the risk of complications related to re-exploration for bleeding after adult cardiac surgery: a systematic review and meta-analysis.
The aim of this study was to evaluate the impact of re-exploration for bleeding after cardiac surgery on the immediate postoperative outcome. ⋯ This study suggests that re-exploration for bleeding after cardiac surgery carries a significantly increased risk of postoperative mortality and morbidity.
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Eur J Cardiothorac Surg · Jan 2012
Multicenter StudyEarly and late outcomes after isolated aortic valve replacement in octogenarians: an Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Study.
The advent of percutaneous aortic valve implantation has increased interest in the outcomes of conventional aortic valve replacement in elderly patients. The current study critically evaluates the short-term and long-term outcomes of elderly (≥80 years) Australian patients undergoing isolated aortic valve replacement. ⋯ Conventional aortic valve replacement in elderly patients achieves excellent outcomes with long-term survival comparable to that of an age-adjusted Australian population. In an era of percutaneous aortic valve implantation, it should still be regarded as the gold standard in the management of aortic stenosis.
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Eur J Cardiothorac Surg · Jan 2012
Temporary percutaneous right ventricular support using a centrifugal pump in patients with postoperative acute refractory right ventricular failure after left ventricular assist device implantation.
Acute right ventricular (RV) failure is a life-threatening condition with a poor prognosis, and sometimes the use of mechanical circulatory support is inevitable. In this article, we describe our experience using a centrifugal pump as a temporary percutaneous right ventricular assist device (RVAD) in patients with postoperative acute refractory RV failure after left ventricular assist device (LVAD) implantation. ⋯ This report suggests that implantation of temporary percutaneous RVAD using a centrifugal pump is a safe alternative in the treatment of postoperative acute refractory RV failure. Ease of device implantation, weaning, explantation, and limited number of complications justify a liberal use.
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Eur J Cardiothorac Surg · Jan 2012
Left atrial appendage occlusion by invagination and double suture technique.
Left atrial appendage (LAA) plays a crucial role as a source of atrial thrombus in patients with atrial fibrillation (AF). Thus, the need to close LAA becomes evident in patients with AF who undergo concomitant mitral valve surgery. Unfortunately, it has been reported a high rate of unsuccessful LAA occlusion, regardless of the technique employed. We propose a safe and simple method for LAA occlusion consisting in invagination of the appendage into the left atrium, followed by two sutures (purse string suture around the base of the LAA and a reinforce running suture).