The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Pulmonary vein stenosis and the pathophysiology of "upstream" pulmonary veins.
Surgical and catheter-based interventions on pulmonary veins are associated with pulmonary vein stenosis (PVS), which can progress diffusely through the "upstream" pulmonary veins. The mechanism has been rarely studied. We used a porcine model of PVS to assess disease progression with emphasis on the potential role of endothelial-mesenchymal transition (EndMT). ⋯ Neonatal pulmonary vein banding in piglets recapitulates critical aspects of clinical PVS and highlights a pathologic profile consistent with EndMT, supporting the rationale for evaluating therapeutic strategies designed to exploit reversibility of upstream pulmonary vein pathology.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Hybrid repair of aortic aneurysm in patients with previous coarctation.
Hybrid operations combining open and endovascular techniques have evolved for patients with complex aortic and coexisting cardiovascular disease. Our objectives were to describe the repair techniques and assess the outcomes in patients undergoing hybrid repair for aneurysm associated with previous aortic coarctation. ⋯ Hybrid repair of postcoarctation repair aneurysm is a safe and effective, less-invasive treatment option for patients with complex anatomy and/or concomitant cardiac disease.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Outcomes and efficacy of thoracic surgery biopsy for tumor molecular profiling in patients with advanced lung cancer.
Molecular testing of patients with advanced non-small cell lung cancer for personalized therapy often is limited by insufficient specimen from nonsurgical biopsies. We measured the feasibility, patient safety, and clinical impact of thoracic surgical tumor biopsy in patients with stage IV non-small cell lung cancer. ⋯ These data suggest that thoracic surgical biopsy can be safely performed in appropriately selected patients with stage IV non-small cell lung cancer and direct personalized therapy and enrollment into relevant clinical trials. Patients with advanced-stage non-small cell lung cancer should be discussed in a multidisciplinary setting to determine the need and strategy for thoracic surgical biopsy for molecular analysis.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Chordal cutting in ischemic mitral regurgitation: a propensity-matched study.
The optimal surgical treatment of ischemic mitral regurgitation (MR) has not been well defined. Second-order chordal cutting (CC), in selected patients, can improve surgical outcomes. ⋯ In selected patients with a BA <145° and coaptation depth ≤10 mm, CC is related to less MR return or persistence, improved EF, and lower New York Heart Association class.
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J. Thorac. Cardiovasc. Surg. · Jul 2014
Effect of pregabalin on cerebral outcome after cardiopulmonary bypass with deep hypothermic circulatory arrest in rats.
Activation of presynaptic voltage-gated calcium channels and release of glutamate play a central role in neuronal necrosis after cardiopulmonary bypass with deep hypothermic circulatory arrest. Pregabalin binds to the α2-δ subunit of voltage-gated calcium channels resulting in reduced glutamate release. The aim of this study is to evaluate the effect of pregabalin on cerebral outcome after cardiopulmonary bypass with deep hypothermic circulatory arrest through an established rat model allowing long-term survival. ⋯ Preemptive treatment with pregabalin conveyed a beneficial influence on functional and histologic cerebral outcome in rats undergoing 60 minutes of deep hypothermic circulatory arrest after cardiopulmonary bypass without any noticeable side effects.