European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2007
Parachute-like technique for off-pump implantation of cardiac support device in isolated and combined procedure.
Cardiac support is a new and promising therapy for refractory heart failure. Only a few previous publications focused on technical implantation of such device. We have developed a new technique that facilitates a consistent and safe implant when the procedure is done without extra-corporeal circulation (ECC). Herein, we report our experience of 60 consecutive CorCap cardiac support device (Acorn Cardiovascular, USA) implantations off-pump for both isolated and combined implantation.
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Eur J Cardiothorac Surg · Nov 2007
Creation of aorto-pulmonary window with pulmonary artery band is not good palliation for hypoplastic left heart syndrome.
A small sub-group of patients with hypoplastic left heart syndrome (HLHS) have normal-sized ascending aorta and arch. An alternative to the Norwood I procedure in these patients is the creation of an aorto-pulmonary (AP) window with a distal pulmonary artery band (PAB). We reviewed our experience with this technique and compared outcomes to the Norwood procedure for HLHS. ⋯ Despite favourable anatomy and shorter ischaemic times, the AP window/PAB technique has a poor outcome compared to the Norwood procedure for HLHS. Low diastolic blood pressure with reversal of descending aortic flow in diastole was a feature of the AP window/PAB circulation. We recommend the Norwood procedure for these sub-types. This may have implications for newer 'hybrid' procedures for HLHS which create a similar palliative circulation.
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Eur J Cardiothorac Surg · Nov 2007
The 6-min walking test early after cardiac surgery. Reference values and the effects of rehabilitation programme.
The 6-min walking test (6MWT) is a simple test, which does not require expensive equipment or advanced training. It has been used in heart failure patients to assess exercise tolerance, the effects of therapy and prognosis. Accordingly, post-surgical cardiac rehabilitation may be a potential field of application of this test. ⋯ Our data suggest that 6MWT is feasible and well tolerated in adult and older patients shortly after uncomplicated cardiac surgery and provides reference values for distance walked after cardiac surgery in this population.
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Eur J Cardiothorac Surg · Nov 2007
Elastomeric surgical sealant for hemostasis of cardiovascular anastomosis under full heparinization.
We developed a novel surgical sealant, a viscous diisocyanated prepolymer, applicable to arterial hemostasis. The purpose of this study is to evaluate hemostatic effect of this surgical sealant under heparinized conditions. ⋯ A novel surgical sealant exhibited rapid and potent hemostatic effect on a moisturized tissue under full heparinization.
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Eur J Cardiothorac Surg · Nov 2007
Addition of a neutrophil elastase inhibitor to the organ flushing solution decreases lung reperfusion injury in rat lung transplantation.
Neutrophil elastase plays an important role in ischemia-reperfusion injury. We hypothesized that the addition of sivelestat, a specific neutrophil elastase inhibitor, to the organ flushing solution would decrease reperfusion injury in a rat single left-lung transplant model. ⋯ Addition of sivelestat to the organ flushing solution ameliorated ischemia-reperfusion injury in a lung transplant model.