European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Dec 2005
Perioperative diagnosis of mesenteric ischemia in acute aortic dissection by transesophageal echocardiography.
Although computed tomography, angiography, or magnetic resonance imaging is most commonly used for diagnosing mesenteric ischemia caused by acute aortic dissection, use of these modalities is often limited in the perioperative period. Thus, we have introduced transesophageal echocardiography to cover this deficit. Purpose of this study is to report the feasibility and accuracy of transesophageal echocardiographic diagnosis on mesenteric ischemia. ⋯ The transesophageal echocardiographic assessment is feasible in nearly all patients and potentially provides correct diagnosis on intestinal ischemia in the perioperative period of acute aortic dissection. Types C and D indicate significant mesenteric malperfusion.
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Eur J Cardiothorac Surg · Dec 2005
Case ReportsDelayed visceral malperfusion in aortic dissection-successful surgical revascularization using a saphenous vein graft.
Obstruction of the thoracoabdominal aorta and/or its branches with subsequent organ ischemia is a frequent complication of aortic dissection. Surgical and percutaneous fenestrations have been used and endovascular stenting has emerged as an additional less invasive approach. In some cases, surgical revascularization may be the most successful procedure. We report two patients who underwent surgical revascularization of the celiac trunk and superior mesenteric artery for delayed abdominal malperfusion due to aortic dissection.
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Eur J Cardiothorac Surg · Dec 2005
The ideal theoretical graft oversizing in valve-sparing aortic operations with a standard tubular or a Valsalva graft.
We sought to determine, by a mathematical model, the ideal theoretical degree of ascending aortic graft oversizing needed to obtain normal sinuses dimension in the reimplantation type of valve-sparing aortic operations. ⋯ A less pronounced graft oversizing is needed to achieve normal-range sinuses size when using a Valsalva graft, the ideal theoretical graft oversizing was +7mm for a standard graft and +3mm for the Valsalva graft, our normograms can be helpful in selecting a proper graft size when performing a valve-sparing aortic procedure.
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Eur J Cardiothorac Surg · Dec 2005
Myocardial protection with intermittent cross-clamp fibrillation: does preconditioning play a role?
Previously, we showed intermittent cross-clamp fibrillation afforded equivalent protection to cardioplegia. This study examined whether protection induced by intermittent cross-clamp fibrillation involves an ischemic preconditioning mechanism. ⋯ The cardioprotective efficacy of intermittent cross-clamp fibrillation was attenuated by protein kinase C inhibition or K(ATP)-channel blockade. Involvement of these putative preconditioning cascade components in association with cardioprotection induced by intermittent cross-clamp fibrillation, suggests a role for the ischemic preconditioning mechanism.
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Eur J Cardiothorac Surg · Dec 2005
Editorial CommentOld skills in a new context. But do we want to use it?