The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2021
Randomized Controlled TrialRandomized trial of bupivacaine with epinephrine versus bupivacaine liposome suspension in patients undergoing minimally invasive lung resection.
Thoracic surgery can cause significant pain, and multiple strategies have been developed to control pain after surgery. We compared 2 bupivacaine formulations given intraoperatively: bupivacaine with epinephrine (1,200,000) or liposomal bupivacaine. ⋯ In a small, randomized study, we did not find significant differences between bupivacaine with epinephrine or liposomal bupivacaine in mitigating pain after minimally invasive lung resection. We currently favor using the less expensive nonliposomal bupivacaine preparations until additional data are available.
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J. Thorac. Cardiovasc. Surg. · May 2021
A novel cross-species model of Barlow's disease to biomechanically analyze repair techniques in an ex vivo left heart simulator.
Barlow's disease remains challenging to repair, given the complex valvular morphology and lack of quantitative data to compare techniques. Although there have been recent strides in ex vivo evaluation of cardiac mechanics, to our knowledge, there is no disease model that accurately simulates the morphology and pathophysiology of Barlow's disease. The purpose of this study was to design such a model. ⋯ This study provides insight into the biomechanics of Barlow's disease, including sharply fluctuating force profiles experienced by elongated chordae prerepair, as well as restoration of primary chordae forces postrepair. Our disease model facilitates further in-depth analyses to optimize the repair of Barlow's disease.
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J. Thorac. Cardiovasc. Surg. · May 2021
Editorial CommentCommentary: "Get moving early!" Inpatient cardiac rehabilitation reduces unplanned hospitalizations.
Inpatient multidisciplinary cardiac rehabilitation is associated with lower unplanned hospital readmissions, compared to conventional cardiac rehabilitation, among patients undergoing cardiac surgery.