The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 1998
Comparative StudyEffects of amrinone, a phosphodiesterase inhibitor, on right ventricular/arterial coupling immediately after cardiac operations.
Amrinone, a selective phosphodiesterase III inhibitor, is reported to have a potent inotropic effect on the left ventricle, but the effects of this drug on right ventricular contractility in the clinical setting are unknown. The concept of ventricular/arterial coupling was applied to investigate the effects of amrinone on right ventricular contractility and afterload with transesophageal echocardiography. ⋯ Right ventricular pressure-area relations obtained with transesophageal echocardiography could successfully separate the simultaneous change in right ventricular systolic mechanics and afterload caused by amrinone. Amrinone caused enhancement of right ventricular contractility and afterload reduction.
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J. Thorac. Cardiovasc. Surg. · Jul 1998
Comparative StudyPartial biventricular repair for complex congenital heart defects: an intermediate option for complicated anatomy or functionally borderline right complex heart.
Partial biventricular repair consists of bidirectional cavopulmonary anastomosis in the presence of separated systemic and pulmonary circulations, with antegrade flow of inferior caval return through an intact or reconstructed pulmonary outflow tract. This versatile procedure may be used as a definitive repair for patients with a functional right heart complex incapable of supporting an entire cardiac output or in patients with complicated anatomy. ⋯ Partial biventricular repair is a versatile strategy that can be used to manage a variety of forms of complex congenital heart disease. Cases for which the repair is useful include those in which complete biventricular repair is unlikely to be achieved because of limited size or function of the right side of the heart and those in which a patient with a ventricle capable of supporting inferior vena caval return was previously placed on a Fontan track.
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J. Thorac. Cardiovasc. Surg. · Jul 1998
Comparative StudyThe outcome of cardiac operations in infants weighing two kilograms or less.
A review of our recent experience of operating on infants weighing 2 kg or less who had congenital heart disease was performed to determine the outcome of early surgical repair or palliation. ⋯ Cardiac operations in a selected group of infants weighing 2 kg or less can provide acceptable hospital survival. In most instances, complete repair is possible with good medium-term outcome in the survivors. Investigation into neurologic outcomes in these patients is warranted.
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J. Thorac. Cardiovasc. Surg. · Jul 1998
Comparative StudyInhibition of interleukin-8 blocks myocardial ischemia-reperfusion injury.
Interleukin-8 is thought to play a role in neutrophil activation and transcapillary migration into the interstitium. Because neutrophils are principal effector cells in acute myocardial ischemia-reperfusion injury, we postulated that the inhibition of interleukin-8 activity with a neutralizing monoclonal antibody directed against rabbit interleukin-8 (ARIL8.2) would attenuate the degree of myocardial injury encountered during reperfusion. ⋯ A specific monoclonal antibody that neutralizes interleukin-8 significantly reduces the degree of necrosis in a rabbit model of myocardial ischemia-reperfusion injury.