The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Multicenter Study Comparative StudyMagnetic resonance imaging versus echocardiography to ascertain the regression of left ventricular hypertrophy after bioprosthetic aortic valve replacement: results of the REST study.
To compare the decrease in left ventricular mass index (LVMI) by magnetic resonance imaging (MRI) versus transthoracic echocardiography (TTE) after aortic valve replacement (AVR) for severe aortic stenosis with Epic and Epic Supra stented porcine bioprostheses (St Jude Medical, Inc, St Paul, Minn). ⋯ A significant decrease in LVMI was measured after AVR with all sizes of both bioprosthetic models. Because of the overestimation of the decrease in LVMI by the Devereux formula, as well as the higher accuracy and reproducibility of cardiac MRI measurements, the latter should be preferred to TTE. An ultimate validation of this thesis could only be done comparing each of these modalities with pathologic examination.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
ReviewUse of energy-based coagulative fusion technology and lung sealants during anatomic lung resection.
Energy-based tissue fusion technology is being increasingly used for vascular division in numerous intra-abdominal applications. Very few data, however, are available regarding the application of this technology in the chest during anatomic lung resection. In the present review, we evaluated the use of energy-based fusion and lung sealants during anatomic lung resection. ⋯ The bipolar tissue fusion system provides a safe and effective technique for the division of the pulmonary arterial and venous branches during anatomic lung resection. Surgical sealants and buttressing adjuncts might reduce perioperative air leak potential.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Multicenter StudyLong-term mechanical circulatory support (destination therapy): on track to compete with heart transplantation?
Average 2-year survival after cardiac transplantation is approximately 80%. The evolution and subsequent approval of larger pulsatile and, more recently, continuous flow mechanical circulatory support (MCS) technology for destination therapy (DT) offers the potential for triage of some patients awaiting cardiac transplantation to DT. ⋯ (1) Evolution from pulsatile to continuous flow technology has dramatically improved 1- and 2-year survivals; (2) DT is not appropriate for patients with rapid hemodynamic deterioration or severe right ventricular failure; (3) important subsets of patients with continuous flow DT now enjoy survival that is competitive with heart transplantation out to about 2 years.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Randomized Controlled Trial Comparative StudyComparing microvascular alterations during minimal extracorporeal circulation and conventional cardiopulmonary bypass in coronary artery bypass graft surgery: a prospective, randomized study.
Minimal extracorporeal circulation (MECC) has been introduced in coronary artery bypass graft (CABG) surgery, offering clinical benefits owing to reduced hemodilution and no blood-air interface. Yet, the effects of MECC on the intraoperative microvascular perfusion in comparison with conventional extracorporeal circulation (CECC) have not been studied so far. ⋯ Orthogonal polarization spectral imaging data reveal an impairment of microvascular perfusion during on-pump CABG. Changes in FCD indicate a faster recovery of the microvascular perfusion in MECC during the reperfusion period. Beneficial recovery of microvascular organ perfusion could partly explain the perioperative advantages reported for MECC.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
ReviewThoracoscopic maneuvers for chest wall resection and reconstruction.
The aim of this report is to describe technical maneuvers used to complete minimally invasive resections of the chest wall successfully. ⋯ Thoracoscopic chest wall resections have been accomplished safely using tools and maneuvers summarized here. Further outcomes research is necessary to identify the benefits of thoracoscopic chest wall resection over an open approach.