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 2013
Focus on the unique mechanisms involved in thoracic aortic aneurysm formation in bicuspid aortic valve versus tricuspid aortic valve patients: clinical implications of a pilot study.
The involvement of different factors in the onset of thoracic aortic aneurysm (TAA) in patients with a bicuspid aortic valve (BAV) vs those with a tricuspid aortic valve (TAV) is well recognized. However, the molecular, genetic and cellular mechanisms driving TAA remain unclear. The aim of this study was to identify the different mechanisms involved in TAA development in patients with BAV vs TAV. ⋯ Our data seem to suggest that TAA in BAV and TAV patients arises from different molecular, cellular and genetic mechanisms. They might help to identify the potential molecular and genetic biomarkers that are useful to detect BAV subjects at high TAA risk, to monitor and treat them differently from those with TAV, with approaches such as the complete removal of the ascending aorta, including the aortic root with or without dilatation.
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Eur J Cardiothorac Surg · Jun 2013
A new and simple classification for sinus of Valsalva aneurysms and the corresponding surgical procedure.
The classification system of Sakakibara and Konno for sinus of Valsalva aneurysm (SVA) is highly complex and seldom utilized in clinical practice. In this study, we propose a new and simple classification system; we suggest a novel approach that utilizes four distinct types of SVAs. ⋯ Surgical repair of SVAs exhibited good long-term results. Our classification of SVA could be potentially helpful for surgical practice. For Type I, the right atrium approach is advised; for Type II, the transaortic approach with a right atrium incision is advised; for Type III, the transaortic approach with pulmonary incision is advised while for Type IV, repair according to the respective situation is advisable.
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Eur J Cardiothorac Surg · Jun 2013
Ischaemic preconditioning prevents the liver inflammatory response to lung ischaemia/reperfusion in a swine lung autotransplant model.
Lung ischaemia/reperfusion (IR) induces a systemic inflammatory response that causes damage to remote organs. The liver is particularly sensitive to circulating inflammatory mediators that occur after IR of remote organs. Recently, remote ischaemic preconditioning has been proposed as a surgical tool to protect several organs from IR. The present study was designed to investigate a possible protective effect of lung ischaemic preconditioning (IP) against the liver inflammatory response to lung IR. ⋯ IP prevented liver injury induced by lung IR through the reduction of proinflammatory cytokines and hepatocyte apoptosis.