The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Aortic root numeric model: annulus diameter prediction of effective height and coaptation in post-aortic valve repair.
The aim of the present study was to determine the influence of the aortic annulus (AA) diameter in order to examine the performance metrics, such as maximum principal stress, strain energy density, coaptation area, and effective height in the aortic valve. ⋯ A decreased AA diameter increased the coaptation height and area, thereby improving the effective height during procedures, which could lead to increased coaptation and better valve performance.
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Long-term results of a strategy of aortic valve repair in the pediatric population.
To determine rate of reoperation subsequent to primary valve repair in a pediatric population. ⋯ Aortic valve repair in pediatric populations is effective in postponing reintervention. The longevity of the repair is shorter after cusp extension and when performed in infants. Caution should be used when performing tricsupidization and cusp extension of bicuspid valves because it can be responsible for mortality related to occlusion of the coronary ostia by patches.
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Comparative StudyIntraoperative hyperthermic chemotherapy perfusion for malignant pleural mesothelioma: an in vitro evaluation.
Hyperthermic chemotherapy perfusion has been used in the treatment of both pleural and peritoneal mesothelioma without an extensive basic science foundation. Clinical data are limited with no prospective randomized trials to support the use of this potentially toxic therapy. We sought to generate basic scientific support for this clinical practice and to define the optimal conditions for use in future clinical trials. ⋯ Intrapleural chemotherapy seems to be most effective when using 2 drug combinations. All mesothelioma cell lines showed no particular sensitivity to heat. The use of hyperthermia alone or with chemotherapy produces at best only a modest effect and does not necessarily support its current clinical use.
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Endothelin and vasopressin influence splanchnic blood flow distribution during and after cardiopulmonary bypass.
Gastrointestinal blood flow can be compromised during and after cardiopulmonary bypass. Endothelin has been shown to be involved in the intestinal microcirculatory disturbance of sepsis. The aim of the present study was to analyze the involvement of the endothelin system on intestinal blood flow regulation during cardiopulmonary bypass and the effect of vasopressin given during cardiopulmonary bypass. ⋯ Cardiopulmonary bypass leads to microvascular impairment of jejunal microcirculation, which is associated with the upregulation of endothelin-1 and endothelin subtype A. The administration of vasopressin minimizes these cardiopulmonary bypass-associated alterations.
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J. Thorac. Cardiovasc. Surg. · Feb 2013
Late outcome of repair of congenital coronary artery fistulas--a word of caution.
We reviewed our experience with repair of congenital coronary artery fistulas. ⋯ Perioperative myocardial infarction is an important complication of ligation of coronary artery fistulas and can contribute to reduced late survival. The tricuspid valve should be evaluated carefully at repair because of the relatively high rate of residual regurgitation in survivors.