Journal of cardiac surgery
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We describe our technique of revascularization of the left anterior descending artery (LAD), using the left internal mammary artery (LIMA) without cardio- pulmonary bypass (CPB), by means of a 4-cm left thoracotomy and video-thoracoscopic harvesting of the LIMA. ⋯ This new procedure enlarges the field of minimally invasive coronary artery bypass grafting techniques.
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Expanded polytetrafluoroethylene (ePTFE) suture has been used clinically for replacement of ruptured mitral valve chordae tendineae. The purpose of this study was to assess mitral valve function after posterior chordal replacement with ePTFE suture. ⋯ This integrated mitral valve finite element model provides a tool to investigate the performance of the valve system. In this study, we have shown that 2-0 ePTFE suture replacement of ruptured posterior chordae tendineae returns the valve to a near normal state, in terms of leaflet stress and coaptation, and chordal stresses.
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Comparative Study
Enhanced blood conservation in primary coronary artery bypass surgery using heparin-bonded circuits with lower anticoagulation.
Despite many advances in blood conservation techniques, a significant proportion of patients undergoing primary coronary revascularization still require homologous transfusions. A comprehensive strategy to diminish perioperative blood loss was developed by integrating many individual components to create an improved blood conservation environment and was prospectively applied to 557 patients undergoing primary coronary artery bypass grafting (CABG) procedures performed in our medical center over a 14-month period. ⋯ In summary, HBCs in conjunction with lower anticoagulation were safely applied in patients undergoing primary CABG with marked improvement in blood conservation, and should be considered for broader clinical use.
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An 18-year-old girl with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (MAPCAs) was reported. Her left-side pulmonary artery was absent, and the blood flow to the left lung was derived from two MAPCAs. ⋯ A handmade trifurcated valved conduit was used to connect the right ventricle and the distal pulmonary arteries. The patient was doing well 3 years after the operation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Long-term prevention of atrial fibrillation after coronary artery bypass surgery: comparison of quinidine, verapamil, and amiodarone in maintaining sinus rhythm.
To evaluate the necessity and efficacy of quinidine fumarate, verapimil, or amiodarone prophylaxis for sinus rhythm maintenance in patients who experienced atrial fibrillation after coronary artery bypass surgery. ⋯ There were no significant differences in the maintenance of sinus rhythm among the four groups, so we suggest that long-term prevention of atrial fibrillation in patients with coronary artery bypass grafting was not necessary at the postdischarge period.