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
Heart transplant graft survival is improved after a reduction in panel reactive antibody activity.
Allosensitization in potential orthotopic heart transplant recipients is evaluated with the panel reactive antibody assay. Sensitized patients have prolonged wait times and increased waitlist and post-transplant mortality. Although low panel reactive antibody activity at the time of orthotopic heart transplantation is associated with improved outcomes, literature regarding the survival benefit of a panel reactive antibody reduction in the sensitized orthotopic heart transplant recipient remains limited. ⋯ Sensitized patients who had a substantial reduction in panel reactive antibody activity had an associated decline in the incidence of graft failure compared with those without a panel reactive antibody activity reduction. These results support efforts to reduce panel reactive antibody activity before orthotopic heart transplantation in patients with high panel reactive antibody activity.
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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
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.