The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialElimination of proinflammatory cytokines in pediatric cardiac surgery: analysis of ultrafiltration method and filter type.
This study was undertaken to assess whether different filter types or ultrafiltration methods influence inflammatory markers in pediatric cardiac surgery. ⋯ The polysulfon filter showed a filtration profile for inflammatory mediators superior to that of the polyamid filter for interleukin 6, tumor necrosis factor, and interleukin 10. Interleukin 6 was most efficiently removed by conventional ultrafiltration with a polysulfon filter, and tumor necrosis factor was best removed by modified ultrafiltration with a polysulfon filter, whereas other inflammatory mediators were not influenced by filter type or ultrafiltration method. Therefore combined conventional and modified ultrafiltration with a polysulfon filter may currently be the most effective strategy for removing inflammatory mediators in pediatric heart surgery.
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J. Thorac. Cardiovasc. Surg. · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialBeating heart revascularization with or without cardiopulmonary bypass: evaluation of inflammatory response in a prospective randomized study.
On-pump beating heart coronary artery surgery provides the opportunity to examine the isolated effect of cardiopulmonary bypass. This prospective randomized study compares the early clinical outcomes and inflammatory response of patients undergoing elective on-pump and off-pump beating heart coronary artery bypass grafting. ⋯ The use of cardiopulmonary bypass alone without global myocardial ischemia secondary to aortic crossclamping and cardioplegic cardiac arrest can trigger intense inflammatory responses.
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J. Thorac. Cardiovasc. Surg. · Jun 2004
Comparative StudySolid and gaseous cerebral microembolization during off-pump, on-pump, and open cardiac surgery procedures.
Neurocognitive dysfunction remains a limitation of cardiac surgery with cardiopulmonary bypass. Intraoperative cerebral microembolization is believed to be one of the most important etiologic factors. Using a new generation of transcranial Doppler ultrasonography, we compared the number and nature of intraoperative microemboli in patients undergoing on-pump and off-pump cardiac surgery procedures. ⋯ Cerebral microembolization is significantly reduced with avoidance of cardiopulmonary bypass. The majority of microemboli occurring during cardiac surgery are gaseous, with a higher proportion of solid microemboli in the on-pump group, and may have a different significance for cerebral injury than solid microemboli. The ability to reliably discriminate gas and solid microemboli may have an important role in the implementation of neuroprotective strategies.
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J. Thorac. Cardiovasc. Surg. · Jun 2004
Comparative StudyHemodynamic and clinical outcomes with the Biocor valve in the aortic position: an 8-year experience.
The aim of this study was to analyze the 8-year experience, survival, prosthetic complications, and hemodynamics of patients who received the Biocor valve, a new-generation tissue valve, in the aortic position. ⋯ The Biocor is an effective bioprosthesis with a low incidence of valve-related complications comparable with that of other second-generation bioprostheses. This stented porcine prosthesis provides satisfactory results in terms of hemodynamics, valve durability, and freedom from reoperation.