The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
ReviewRenal and visceral protection in thoracoabdominal aortic surgery.
Open thoracoabdominal aortic aneurysm (TAAA) repair traditionally carries substantial perioperative morbidity and mortality, primarily from distal aortic ischemia. Advances in surgical techniques, adjuncts, and strategies have greatly improved outcomes. ⋯ Contemporary protective strategies allow open TAAA repair with substantially fewer renal and visceral ischemic complications. Although bowel ischemia is uncommon, renal failure remains a concern, especially in extent II and extent III TAAA repairs. Additional studies are needed to identify and improve renal protection strategies.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative StudyShould early extubation be the goal for children after congenital cardiac surgery?
We sought to determine the feasibility and assess the clinical outcomes associated with an early extubation strategy for all children undergoing congenital heart surgery, including neonates (age, <30 days). ⋯ Most children undergoing congenital heart surgery can be extubated in the operating room. Most neonates, including many undergoing complex procedures, can be extubated within the first 24 hours after surgery. Early extubation was associated with low morbidity rates and short lengths of intensive care unit and hospital stays.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative Study Observational StudyThe influence of positive end-expiratory pressure on stroke volume variation in patients undergoing cardiac surgery: an observational study.
Measurements of stroke volume variation for volume management in mechanically ventilated patients are influenced by various factors, such as tidal volume, respiratory rate, and chest/lung compliance. However, research regarding the effect of positive end-expiratory pressure on stroke volume variation is limited. ⋯ The threshold value of stroke volume variation in predicting fluid responsiveness may change when positive end-expiratory pressure 10 cmH2O is applied. This must be considered when stroke volume variation is used to detect the fluid responsiveness to prevent volume overload in this mechanical ventilation setting.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Comparative StudyClinical features of acute aortic dissection from the Registry of Aortic Dissection in China.
To establish a systematic registry of aortic dissection in China, assess the clinical features of Chinese patients with acute aortic dissection (AAD), and compare our results with the data published by the International Registry of Acute Aortic Dissection (IRAD). ⋯ The first Sino-RAD, including 15 large cardiovascular centers throughout China, was established. Our data were compared with those reported by IRAD. We found that, compared with Western populations, Chinese patients with AAD showed 6 differences, including earlier onset, more male patients, a low incidence of hypertension, a low incidence of chest pain, a high incidence of back pain, great differences in the choice of therapeutic strategies, and relatively low in-hospital mortality.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Unidirectional valved patch closure of ventricular septal defects with severe pulmonary arterial hypertension: hemodynamic outcomes.
The purpose of the present study was to study the midterm hemodynamic outcomes of unidirectional valved patch closure of ventricular septal defects (VSDs) in patients with VSD and pulmonary arterial hypertension (PAH). ⋯ Unidirectional valved patch closure of VSD is a promising technique for patients with a large VSD and severe PAH. It had a favorable effect on the immediate, early, and midterm clinical outcomes and hemodynamic parameters.