The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Comparative StudyA propensity score-matched comparison of deep versus mild hypothermia during thoracoabdominal aortic surgery.
By using deep hypothermic circulatory arrest and non-deep hypothermic circulatory arrest approaches, we examined the impact of distal ischemia time and temperature on intra-abdominal reversible adverse outcomes and permanent adverse outcomes during descending thoracic aortic and thoracoabdominal aortic aneurysm operations. ⋯ During descending thoracic aortic and thoracoabdominal aortic aneurysm repairs, the use of deep hypothermic circulatory arrest results in improved postoperative adverse outcome rates compared with non-deep hypothermic circulatory arrest techniques. The development of reversible adverse outcomes is strongly associated with the development of permanent adverse outcomes.
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Very low-birth-weight infants with congenital cardiac lesions: is there merit in delaying intervention to permit growth and maturation?
Low birth weight and prematurity and are known risks for mortality in congenital heart lesions. It is not known whether risks of delayed intervention are offset by benefits of growth and maturation. We explored this question. ⋯ For very low-birth-weight neonates (<2.0 kg) with congenital heart defects, imposed delays in intervention neither compromise nor improve survival. Other factors instead appear to account for survival differences, including lesion type, associated noncardiac congenital defects, and antenatal diagnosis.
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Pulmonary artery sling: current results with cardiopulmonary bypass.
We have used cardiopulmonary bypass with left pulmonary artery reimplantation for pulmonary artery sling repair since 1985. This review presents our current results with this technique, emphasizing the importance of diagnosis and treatment of frequently associated tracheal stenosis. ⋯ Pulmonary artery sling is best repaired with median sternotomy, cardiopulmonary bypass, and left pulmonary artery reimplantation. This resulted in uniformly patent left pulmonary arteries in all patients. Preoperative computed tomography imaging, echocardiography, and bronchoscopy are essential for precise operative planning. The frequently associated tracheal stenosis is best repaired with slide tracheoplasty.
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Randomized Controlled Trial Multicenter Study Comparative StudyPredictors and impact of postoperative atrial fibrillation on patients' outcomes: a report from the Randomized On Versus Off Bypass trial.
The study objective was to determine the predictors of postoperative atrial fibrillation (POAF) in patients randomized to conventional coronary artery bypass graft (on-pump coronary artery bypass [ONCAB]) versus beating heart coronary surgery (off-pump coronary artery bypass [OPCAB]). ⋯ In the Randomized On Versus Off Bypass trial, the strategy of revascularization did not affect the rate of POAF. Age, race, and hypertension were predictors of POAF. POAF was independently associated with a higher short-term morbidity and higher 1-year mortality rates.