The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Repair of naphthalene-induced acute tracheal injury by basal cells depends on β-catenin.
Little is known about the role of Wnt/β-catenin in postnatal airway homeostasis and basal cell function. This study aimed to investigate the role of Wnt signaling in the self-renewal of basal cells and the involvement of β-catenin in tracheal repair after naphthalene-induced injury. ⋯ Basal cells serve as stem cells in the tracheal epithelium, regenerating and maintaining tracheal epithelial cells in a mouse model of tracheal injury. β-Catenin is required for proliferation and self-renewal of tracheal epithelial cells.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Mitral valve annular downsizing forces: implications for annuloplasty device development.
Mitral valve repair with annulus downsizing is a popular surgical procedure for functional mitral regurgitation. We investigated the effects of externally applied downsizing on the observed in-plane forces and valvular dimensions. ⋯ Segmental mitral valve annulus downsizing increased in-plane traction suture forces and has a significant influence on the in-plane biomechanics. These results have implications for device design in terms of mechanical strength requirements and can be used to supplement boundary conditions for computational left heart models.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Three-dimensional valve repair-the better care? Midterm results of a saddle-shaped, rigid annuloplasty ring in patients with ischemic mitral regurgitation.
Undersized ring annuloplasty is the treatment of choice for functional mitral regurgitation. However, recurrence of mitral regurgitation within the first years is frequent. The aim of this study was to analyze the functional and clinical outcome after mitral valve repair with the 3-dimensional saddle-shaped Edwards GeoForm (Edwards Lifesciences LLC, Irvine, Calif) annuloplasty ring in patients with ischemic mitral regurgitation. ⋯ Mitral valve repair with the 3-dimensional saddle-shaped Edwards GeoForm annuloplasty ring in case of ischemic mitral regurgitation shows a low rate of recurrent regurgitation at 4 years. Clinically relevant mitral stenosis was not detected. The importance of secure anchoring of the device in the mitral annulus has to be emphasized to prevent ring dehiscence.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Predictors of late aortic events after Stanford type B acute aortic dissection.
Patients with Stanford type B acute aortic dissection usually receive medical treatment during the acute phase. The present study aimed to elucidate the factors predicting late aortic events in patients treated conservatively for acute type B dissections. ⋯ When patients have a maximum aortic diameter of ≥40 mm or ulcer-like projections at onset, early surgical intervention should be considered to prevent positive remodeling of the aorta.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Salvage periaortic pericardial baffle equalizes mortality in bleeding patients undergoing aortic surgery.
Bleeding is a potentially serious complication of aortic surgery. We report our experience with the use of a periaortic bovine pericardial baffle to control intractable intraoperative bleeding. ⋯ Patients requiring salvage periaortic pericardial baffle for intractable intraoperative hemorrhage experienced an operative mortality similar to that in the remaining patients undergoing aortic surgery. Infectious endocarditis requiring root replacement or reoperative aortic surgery should alert the surgeon to the potential need for baffle placement, including prophylactic transverse sinus closure.