The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Quantifying the effects of circulatory arrest on acute kidney injury in aortic surgery.
We aim to investigate the association between parameters surrounding circulatory arrest and postoperative acute kidney injury in aortic surgery. ⋯ Within the range of our clinical practice, prolonged lower-body ischemia duration was not independently associated with postoperative acute kidney injury, whereas nadir temperature was.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Stem Cell-Derived Exosome Patch with Coronary Artery Bypass Graft Restores Cardiac Function in Chronically Ischemic Porcine Myocardium.
This study aimed to investigate whether or not the application of a stem cell-derived exosome-laden collagen patch (EXP) during coronary artery bypass grafting (CABG) can recover cardiac function by modulating mitochondrial bioenergetics and myocardial inflammation in hibernating myocardium (HIB), which is defined as myocardium with reduced blood flow and function that retains viability and variable contractile reserve. ⋯ Exosomes recovered cardiomyocyte mitochondrial respiration and reduced myocardial inflammation through paracrine signaling, resulting in improved cardiac function.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Repeat pulmonary thromboendarterectomy outcomes: A 15-year single-center retrospective review.
Chronic thromboembolic pulmonary hypertension is potentially curable via pulmonary thromboendarterectomy. A minority of patients experience recurrence of their symptoms and are eligible for repeat pulmonary thromboendarterectomy. However, little data exist regarding risk factors and outcomes for this patient population. ⋯ This is the largest reported series of repeat pulmonary thromboendarterectomy surgery. Despite an increase in postoperative complications, this study demonstrates that repeat pulmonary thromboendarterectomy surgery can result in significant hemodynamic improvement with acceptable surgical mortality in an experienced center.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
The intersection of community socioeconomic factors with gender on outcomes after thoracic aortic surgery.
We evaluated the relationship among community socioeconomic factors (poverty, income, and education), gender, and outcomes in patients who underwent ascending aortic, root, and arch surgery. ⋯ This study is among the first to examine the association among community socioeconomic factors, gender, and outcomes in patients who undergo proximal aortic surgery. Female gender predicted a composite adverse outcome. In the elective patients, most adverse outcomes were significantly less in men. In the propensity-matched patients, all community socioeconomic factors favored men, although not significantly. Larger studies with patient-level socioeconomic information are needed.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Risk Profile And Operative Outcomes In Marfan Syndrome Versus Non-Marfan Patients Undergoing Thoracoabdominal Aortic Aneurysm Repair.
To compare operative and long-term outcomes between patients with and without Marfan syndrome undergoing thoracoabdominal aortic aneurysm repair. ⋯ Open thoracoabdominal aortic aneurysm repair can be performed with similar operative outcomes in patients with and without Marfan syndrome despite differing risk profiles. Operative/perioperative strategies must be tailored to specific needs of each patient to optimize outcomes.