The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2016
Editorial CommentAnemia or blood transfusions: There is no winner.
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J. Thorac. Cardiovasc. Surg. · Nov 2016
Review Meta AnalysisReintervention after endovascular repair for aortic dissection: A systematic review and meta-analysis.
Thoracic endovascular aortic repair has been chosen as a less-invasive alternative to open surgery for the treatment of aortic dissections; however, the advantages have been challenged by the postoperative reintervention during the follow-up period. This study aimed at evaluating the incidence, reasons, and potential risk factors for reintervention. ⋯ Current data suggest that the incidence of reintervention after endovascular therapy is relatively high during midterm follow-up. Advanced age of onset is a risk factor and diabetes mellitus is a protective factor of reintervention after endovascular therapy. The possible mechanism that diabetes mellitus protects patients from reintervention should be explored further.
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J. Thorac. Cardiovasc. Surg. · Nov 2016
Balancing pulmonary blood flow: Theory, in vitro measurements, and clinical correlation of systemic-to-pulmonary shunt banding.
Size mismatch between body and a systemic-to-pulmonary shunt can result in excessive pulmonary blood flow, compromising systemic oxygen delivery. Previously reported techniques to mechanically restrict shunt flow lack precision and reproducibility. We developed a formula for shunt banding and assessed its efficacy and reproducibility by in vitro and clinical measurements. ⋯ Our formulas and surgical strategy offer a new approach to controlling excessive pulmonary blood flow in shunt-dependent circulations in an effective and predictable way. The best reproducibility was achieved in small, thin-walled shunts. This strategy was most effective in patients with pulmonary overcirculation without hemodynamic decompensation.