The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2020
Preemptive pain-management program is associated with reduction of opioid prescriptions after benign minimally invasive foregut surgery.
The opioid crisis is partly due to opioids prescribed after elective surgery. We sought to determine if a preemptive pain-management program would be associated with opioid-free discharge after benign foregut surgery. ⋯ The preemptive pain-management program was associated with opioid-free discharge after minimally invasive foregut surgery. This study provides a strategy to reduce opioid prescriptions after foregut surgery and, if implemented nationally, could decrease the amount of opioids used in the community.
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J. Thorac. Cardiovasc. Surg. · Feb 2020
Y-graft modification to the Fontan procedure: Increasingly balanced flow over time.
The use of Y-grafts for Fontan completion is hypothesized to offer more balanced hepatic flow distribution (HFD) and decreased energy losses. The purpose of this study was to evaluate the hemodynamic performance of Y-grafts over time using serial cardiac magnetic resonance data and to compare their performance with extracardiac Fontan connections. ⋯ Y-grafts showed significantly more balanced HFD over a 3-year follow-up without an increase in total cavopulmonary connection resistance, and therefore may be a valuable option for Fontan completion. Additional follow-up data at longer follow-up times are still needed to thoroughly characterize the potential advantages of Y-graft use.
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J. Thorac. Cardiovasc. Surg. · Feb 2020
Evaluation of a hybrid small caliber vascular graft in a rabbit model.
A hybrid small-caliber artificial vascular graft based on bilayer porcine small intestinal submucosa (SIS) with curdlan and dipyridamole mixture film serving as the so-called sandwich filler was developed for biological performance evaluation. We evaluated the performance of the graft and filler. ⋯ The novel hybrid small caliber artificial vascular graft exhibited an improvement in revascularization resulting in high patency rate.