The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2008
Remote ischemic preconditioning elaborates a transferable blood-borne effector that protects mitochondrial structure and function and preserves myocardial performance after neonatal cardioplegic arrest.
Remote ischemic preconditioning is known to elicit production of a blood-borne cardioprotective factor that is infarct sparing in models of ischemia-reperfusion injury and myocardial damage reducing after cardiopulmonary bypass in human subjects. The mechanism of protection remains incompletely understood. In this study, we examined effects on mitochondrial structure and function in a noninfarct model of cardioplegic arrest. ⋯ The cardioprotective factor in plasma dialysate after remote preconditioning preserves mitochondrial structure and function in a noninfarct cardioplegic arrest model. This protection is associated with preservation of global myocardial performance.
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J. Thorac. Cardiovasc. Surg. · Aug 2008
Sinus node dysfunction after repair of partial anomalous pulmonary venous connection.
Sinus node dysfunction is known as a major complication after repair of partial anomalous pulmonary venous connection. We retrospectively analyzed the results of the atrial wall flap technique compared with the results of patch repair or direct suturing in the intra-atrial tunnel technique. ⋯ The atrial flap technique, which requires incision or suture crossing the crista terminalis, could cause sinus node dysfunction, whereas the intra-atrial rerouting method with a patch or direct suture maintains normal sinus node function postoperatively.
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J. Thorac. Cardiovasc. Surg. · Aug 2008
Long-term clinical outcome of coronary artery stenting or coronary artery bypass grafting in patients with multiple-vessel disease.
Recent large-scale observational studies have shown better outcomes after coronary artery bypass grafting than after angioplasty or stenting in patients with multiple-vessel disease. The time frames of these studies, however, include periods of varying behavior with respect to patient selection, stent technique and design, and medical therapy. Our objective was to examine long-term outcomes of coronary stenting and coronary artery bypass grafting, including those performed in the contemporary era of aggressive medical therapy. ⋯ During a 9-year period, in physician-selected patients with favorable demographic characteristics for both revascularization procedures, coronary artery bypass grafting was associated with better long-term survival than stent-assisted angioplasty.
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J. Thorac. Cardiovasc. Surg. · Aug 2008
Thoracoscopic lobectomy: introduction of a new technique into a thoracic surgery training program.
Thoracoscopic lobectomy has been demonstrated to be safe and oncologically sound. However, few thoracic surgeons perform the operation. We hypothesized that use of a predetermined, stepwise plan for introduction of thoracoscopic lobectomy into a thoracic surgical training program would facilitate safe learning of the technique. ⋯ Introduction of thoracoscopic lobectomy into an academic thoracic surgical practice can be achieved safely if a stepwise transition is invoked. Training of thoracic surgical residents and additional staff can thus be effectively accomplished.