The Journal of thoracic and cardiovascular surgery
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Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. ⋯ Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum.
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J. Thorac. Cardiovasc. Surg. · Aug 2017
Computational fluid dynamics simulation of the right subclavian artery cannulation.
The purpose of this study was to evaluate the efficacy of right subclavian artery cannulation using computational fluid dynamics. ⋯ Right subclavian artery cannulation was cerebroprotective, especially on the right side.
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J. Thorac. Cardiovasc. Surg. · Aug 2017
Observational StudyPerioperative NT-proBNP level: Potential prognostic markers in children undergoing congenital heart disease surgery.
To assess the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at different time points and early outcome, and to evaluate the reliability of NT-proBNP level as a predictor of early outcome after surgery in a large series of children with congenital heart disease (CHD). ⋯ After CHD surgery, the perioperative NT-proBNP levels might be powerful markers to identify subjects at higher risk for worse outcome.
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J. Thorac. Cardiovasc. Surg. · Aug 2017
Implications and outcomes of cardiac grafts refused by pediatric centers but transplanted by adult centers.
According to Organ Procurement Transplant Network policy, hearts from donors age <18 years are offered to pediatric recipients before being offered to adults of the same health status. We aimed to analyze differences in the use of adolescent donor hearts between adult and pediatric candidates and also to analyze the outcomes of pediatric candidates in which an adolescent donor heart was refused and later used in an adult recipient. ⋯ A significant number of adolescent donor hearts that are refused by pediatric centers result in excellent post-transplantation outcomes in adult recipients. One in 10 pediatric candidates died on the waitlist after refusal of these hearts used by adult recipients. This warrants careful evaluation of the refusal criteria used by pediatric centers. Encouragingly, there now appears to be a trend toward an increased use of adolescent donor hearts by pediatric centers.
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J. Thorac. Cardiovasc. Surg. · Aug 2017
Hypoxia modulates cell migration and proliferation in placenta-derived mesenchymal stem cells.
For more than a decade, stem cells isolated from different tissues have been evaluated in cell therapy. Among them, the human bone marrow-derived mesenchymal stem cells (hBM-MSCs) were investigated extensively in the treatment of myocardial infarction. Recently, the human placenta-derived mesenchymal stem cells (hPD-MSCs), which are readily available from a biological waste, appear to be a viable alternative to hBM-MSCs. ⋯ Our current results suggest that hPD-MSCs could represent a viable and effective alternative to hBM-MSCs for translational studies in cardiocellular repair.