The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2012
Serial multidetector computed tomography assessment of left ventricular reverse remodeling, mass, and regional wall stress after restrictive mitral annuloplasty in dilated cardiomyopathy.
To evaluate serial data on left ventricular and myocardial reverse remodeling after restrictive mitral annuloplasty. ⋯ Our findings indicate that ventricular reverse remodeling occurs soon after restrictive mitral annuloplasty. In contrast, myocardial reverse remodeling (ie, regression of myocardial hypertrophy) occurs over time between the early and late postoperative periods. Our data also suggest that the late improvement in left ventricular systolic performance might be attributable to a decrease in the left ventricular afterload.
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J. Thorac. Cardiovasc. Surg. · Apr 2012
Impact of early fundoplication or gastrostomy tube on midterm outcomes for patients with single ventricle.
Patients with single-ventricle heart disease experience early and late failure during and after staged palliation. Little is known about the factors related to continued risk of transplantation and mortality after completion of staged palliation. The long-term outcome of patients with single-ventricle disease who require a gastric fundoplication early in life has not been assessed. ⋯ The need for early fundoplication or gastrostomy is associated with decreased transplant-free survival for patients with palliated single-ventricle heart disease.
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J. Thorac. Cardiovasc. Surg. · Apr 2012
Implementation of a comprehensive blood conservation program can reduce blood use in a community cardiac surgery program.
The study objective was to determine the effects of implementing a blood conservation algorithm on blood product use and outcomes in a community cardiac surgery program. ⋯ Implementation of a comprehensive blood conservation algorithm can be rapidly introduced, leading to reductions in blood and component use with no detrimental effect on early outcomes. Point-of-care testing can direct component transfusion in coagulopathic cases, with most coagulopathic patients requiring platelets. Further research will determine the effects of reduced transfusions on long-term outcomes.
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J. Thorac. Cardiovasc. Surg. · Apr 2012
Spinal cord protective strategies during descending and thoracoabdominal aortic aneurysm repair in the modern era: the role of intrathecal papaverine.
An array of neuroprotective strategies has evolved to limit spinal cord injury during descending thoracic aneurysm and thoracoabdominal aortic aneurysm repair. This study prospectively assessed the neuroprotective impact of intrathecal papaverine added to other techniques in aortic aneurysm repairs. ⋯ Adding intrathecal papaverine to the neuroprotective protocol for descending thoracic aneurysm and thoracoabdominal aortic aneurysm repairs may enhance spinal cord perfusion and provide additional spinal cord protection.
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J. Thorac. Cardiovasc. Surg. · Apr 2012
Comparative StudyComparative effectiveness of minimally invasive versus traditional sternotomy mitral valve surgery in elderly patients.
This study assessed comparative effectiveness of minimally invasive versus traditional sternotomy mitral valve surgery in elderly patients. ⋯ Among elderly patients, minimally invasive mitral valve surgery is associated with slightly longer crossclamp and bypass times but with equivalent morbidity and mortality and shorter hospitalization, decreased resource use, and improved postoperative functional status.