The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2012
Randomized Controlled TrialFeasibility of landiolol and bisoprolol for prevention of atrial fibrillation after coronary artery bypass grafting: a pilot study.
We previously performed a trial of intravenous landiolol hydrochloride during and after cardiac surgery (the PASCAL trial) and demonstrated a preventive effect on postoperative atrial fibrillation (AF). In the present study, we investigated the efficacy of increasing the dose and administration period of landiolol for prevention of postoperative AF, as well as the effect of oral bisoprolol in the early postoperative period. ⋯ Landiolol and bisoprolol prevented postoperative AF. The anti-ischemic, anti-inflammatory, and anti-oxidant effects of these beta-blockers presumably inhibited the onset of AF.
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J. Thorac. Cardiovasc. Surg. · Nov 2012
Multicenter StudySelective antegrade cerebral perfusion and mild (28°C-30°C) systemic hypothermic circulatory arrest for aortic arch replacement: results from 1002 patients.
The use of selective antegrade cerebral perfusion (ACP) makes deep hypothermia nonessential for aortic arch replacement. Consequently, a growing tendency to increase the body temperature during circulatory arrest with ACP has recently been reported from various institutions. However, very little is known about the clinical effect of different modes of ACP (unilateral vs bilateral) on neurologic morbidity. Also, the safe limits of this approach for spinal chord and visceral organ protection are yet to be defined. ⋯ Current data suggest that ACP and mild systemic hypothermic circulatory arrest can be safely applied to complex aortic arch surgery even in a subgroup of patients with up to 90 minutes of ACP. Unilateral ACP offers at least equal brain and visceral organ protection as bilateral ACP and might be advantageous in that it reduces the incidence of embolism arising from surgical manipulation on the arch vessels.
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J. Thorac. Cardiovasc. Surg. · Nov 2012
Clinical TrialThoracoscopic localization of intraparenchymal pulmonary nodules using direct intracavitary thoracoscopic ultrasonography prevents conversion of VATS procedures to thoracotomy in selected patients.
To investigate the feasibility, accuracy, and effect on conversion rates of intracavitary video-assisted thoracoscopic surgery ultrasonography (VATS-US) for localization of difficult to visualize pulmonary nodules. ⋯ Intracavitary VATS-US is a real-time, feasible, reliable, and effective method of localization of intraparenchymal pulmonary nodules during selected VATS wedge resection procedures and can decrease the conversion rates to thoracotomy or lobectomy.
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J. Thorac. Cardiovasc. Surg. · Nov 2012
Multicenter StudyVery long-term results (up to 17 years) with the double-orifice mitral valve repair combined with ring annuloplasty for degenerative mitral regurgitation.
The very long-term results of the double-orifice mitral valve repair are unknown. The aim of this study was to assess the late clinical and echocardiographic outcomes of this technique in patients with degenerative mitral regurgitation. ⋯ The double-orifice repair combined with ring annuloplasty provides very satisfactory long-term results in patients with degenerative mitral regurgitation in the setting of bileaflet and anterior leaflet prolapse.
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J. Thorac. Cardiovasc. Surg. · Nov 2012
Lung transplantation in patients 70 years old or older: have outcomes changed after implementation of the lung allocation score?
The objective of the present study was to evaluate whether the outcomes of lung transplantation in patients aged 70 years or older have changed after implementation of the lung allocation score in May 2005. ⋯ Recipients aged 70 years or older were a larger proportion of overall lung transplantation patients after implementation of the lung allocation score. Although associated with significantly increased post-lung transplantation mortality in the pre-lung allocation score era, age 70 years or older is currently associated with outcomes comparable to those of patients aged 60 to 69 years. Therefore, age 70 years or older should not serve as an absolute contraindication to lung transplantation in the lung allocation score era.