The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Intraoperative bypass graft flow in intra-aortic balloon pump-supported patients: differences in arterial and venous sequential conduits.
The intra-aortic balloon pump is used worldwide as an anti-ischemic strategy. However, little is known about the modifications of the graft flowmetry during use of intra-aortic balloon pump. ⋯ In this analysis, use of intra-aortic balloon pump was associated with improved diastolic and mean blood flow in bypass grafts. Arterial and sequential grafts were associated with greater improvements in blood flow and surplus graft flow. Graft failure was associated with poor transit-time flow results, high pulsatility index values, and absent surplus graft flow.
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Hybrid endovascular aortic arch repair using branched endoprosthesis: the second-generation "branched" open stent-grafting technique.
We advanced the open stent-grafting technique with a branched endoprosthesis, which reconstructs simultaneously the cervical branches and descending aorta within an acceptably short interval of deep hypothermic circulatory arrest. In this study, we evaluated the efficacy of this new technique and assessed the early and midterm results. ⋯ Aortic arch repair with branched open stent grafting is an effective technique with satisfactory early results. In midterm analysis, cervical branch events were acceptably rare and controllable. This technique could be an attractive alternative to conventional total arch replacement.
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Randomized Controlled Trial Comparative StudyThe effects of normoxic versus hyperoxic cardiopulmonary bypass on oxidative stress and inflammatory response in cyanotic pediatric patients undergoing open cardiac surgery: a randomized controlled trial.
This study investigates the effects of controlled reoxygenation cardiopulmonary bypass on oxidative stress, inflammatory response, and organ function in children undergoing repair of cyanotic congenital heart defects. ⋯ Controlled reoxygenation on starting cardiopulmonary bypass is associated with reduced myocardial damage, oxidative stress, and cerebral and hepatic injury compared with hyperoxic bypass and similar whole body inflammatory and stress response in cyanotic children undergoing open cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Right but not left ventricular function recovers early after living-donor lobar lung transplantation in patients with pulmonary arterial hypertension.
The aim of this study was to evaluate right and left ventricular functions in patients with pulmonary arterial hypertension after living-donor lobar lung transplantation compared with those without hypertension. ⋯ Right ventricular function recovered early after living-donor lobar lung transplantation in the PAH group. In contrast, recovery of left ventricular function required 6 to 12 months. Improved cardiac function was sustained for up to 3 years, suggesting long-term durability of cardiac function recovery after living-donor lobar lung transplantation.
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer.
The optimal surgical technique for lobectomy in lung cancer is not well defined. Proponents of video-assisted thoracic surgery (VATS) hypothesize that less trauma leads to quicker recovery, whereas those who advocate thoracotomy claim it as an oncologically superior procedure. However, a well-balanced comparison of the two procedures is lacking in the literature. ⋯ VATS lobectomy and thoracotomy demonstrated similar 5-year survivals. However, VATS lobectomy was associated with fewer complications and shorter length of hospital stay.