The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2013
Understanding right ventricular dysfunction and functional tricuspid regurgitation accompanying mitral valve disease.
The study objective was to correlate the degree of tricuspid regurgitation with clinical indicators of right-sided heart failure and both qualitative and quantitative measures of right-sided heart morphology and function in patients with degenerative mitral valve disease. ⋯ Functional tricuspid regurgitation accompanying mitral valve disease is associated with proportional changes in right-sided heart morphology; however, severe tricuspid regurgitation is nearly always associated with right ventricular dysfunction, suggesting a synergistic relationship. Right ventricular dysfunction is likely as important as tricuspid regurgitation because it offers an explanation for the negative prognostic impact of tricuspid regurgitation and has implications for the clinical management of patients.
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J. Thorac. Cardiovasc. Surg. · May 2013
Outcome and prognostic factors of pleural mesothelioma after surgical diagnosis and/or pleurodesis.
The objective of this study was to evaluate long-term survival and prognostic factors in patients with malignant pleural mesothelioma. ⋯ Median survival in an unselected population of patients with malignant pleural mesothelioma treated nonsurgically is 12 months. Nonepithelioid histology, older age, abnormal C-reactive protein levels, and leukocytosis are independent predictors of worse survival.
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J. Thorac. Cardiovasc. Surg. · May 2013
Comparative StudyOutcomes after thymectomy in class I myasthenia gravis.
The role of extended thymectomy in the treatment of class I myasthenia gravis is still controversial. This study compared the long-term outcomes of operated and nonoperated patients allocated according to their will. ⋯ Extended thymectomy achieved a more rapid remission than after nonsurgical treatment of class I myasthenia gravis. Significantly better outcomes resulted when thymectomy was performed within 6 months from the onset of symptoms.
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J. Thorac. Cardiovasc. Surg. · May 2013
Tracheal regeneration: evidence of bone marrow mesenchymal stem cell involvement.
Recent advances in airway transplantation have shown the ability of ex vivo or in vivo tracheal regeneration with bioengineered conduits or biological substitutes, respectively. Previously, we established a process of in vivo-guided tracheal regeneration using vascular allografts as a biological scaffold. We theorized that tracheal healing was the consequence of a mixed phenomenon associating tracheal contraction and regeneration. The aim of the present study was to determine the role that bone marrow stem cells play in that regenerative process. ⋯ The results of the present study imply a role for bone marrow stem cells in tracheal regeneration after aortic allografting. Studies are necessary to identify the local and systemic factors stimulating that regenerative process.
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J. Thorac. Cardiovasc. Surg. · May 2013
Assessment of cardiovascular function by combining clinical data with a computational model of the cardiovascular system.
A sufficient understanding of patients' cardiovascular status is necessary for doctors to make the best decisions with regard to the treatment of cardiovascular disease; however, it is often not available because of the limitation of clinical measurements. The objective of this study was to examine whether cardiovascular function can be assessed quantitatively and for specific patients by combining clinical data with a computational model of the cardiovascular system. ⋯ The current study demonstrates the feasibility of assessing cardiovascular function quantitatively by combining clinical data with a cardiovascular model. In particular, the assessment utilizes the measurements already in use or available in clinical settings, enhancing the clinical potential of the proposed method.