The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2012
Long-term importance of right ventricular outflow tract patch function in patients with pulmonary regurgitation.
Chronic pulmonary regurgitation (PR) has deleterious effects on right ventricular (RV) function in repaired tetralogy of Fallot (ToF). However, there are little data regarding right ventricular outflow tract (RVOT) contractile dysfunction in response to chronic PR and on both RV and LV volumes and function. ⋯ RV outflow tract patch dysfunction in repaired ToF is responsible for higher end-systolic volumes and thus lower global measures of ventricular systolic function. These findings were not evident in cases of PS treated with valvotomy with comparable amount of PR. These observations highlight the importance of the initial repair surgery in ToF for late outcomes.
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J. Thorac. Cardiovasc. Surg. · May 2012
Benefits of ambulatory axillary intra-aortic balloon pump for circulatory support as bridge to heart transplant.
Axillary intra-aortic balloon pump therapy has been described as a bridge to transplant. Advantages over femoral intra-aortic balloon pump therapy include reduced incidence of infection and enhanced patient mobility. We identified the patients who would benefit most from this therapy while awaiting heart transplantation. ⋯ Axillary intra-aortic balloon pump therapy provides excellent support for selected patients as a bridge to transplant. The majority of the patients were successfully bridged to transplant and discharged. Although this therapy has been described in previous studies, this is the largest series to incorporate a regimen of aggressive ambulation with daily measurements of distances walked.
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J. Thorac. Cardiovasc. Surg. · May 2012
Changes in left atrioventricular valve geometry after surgical repair of complete atrioventricular canal.
The most common reason for late surgical reintervention after repair of complete atrioventricular canal defects is the development of left atrioventricular valve regurgitation. We sought to determine the changes in left atrioventricular valve geometry after surgical repair that may predispose to regurgitation. ⋯ Complete atrioventricular canal repair leads to left atrioventricular valve annular shape change with increased area and circular shape. The change in left atrioventricular valve annulus shape appeared to be mainly due to increased circumference in the posterior free wall of the annulus. These findings may provide a mechanism for the progression of central regurgitation seen after complete atrioventricular canal repair and a potential solution.