The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Decrease in inflammatory response does not prevent placental dysfunction after fetal cardiac bypass in goats.
One of the most significant responses to fetal cardiac bypass is severe placental dysfunction characterized by increased vascular resistance. We tested the hypothesis that fetal cardiac bypass triggers the activation of nuclear factor kappa-B (NF-KB), a major regulator of inflammatory response, and that pharmacologic inhibition of NF-KB activation by pyrrolidine dithiocarbamate alleviates fetal cardiac bypass-induced placental dysfunction. ⋯ Fetal cardiac bypass-induced inflammatory response possibly mediated by NF-KB caused placental dysfunction. Pharmacologic inhibition of NF-KB activation and decrease in the inflammatory response did not alleviate the placental dysfunction.
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Congenital heart surgery in infants: effects of acute kidney injury on outcomes.
We sought to characterize factors and outcomes associated with postoperative acute kidney injury in infants undergoing cardiac surgery. ⋯ Perioperative acute kidney injury is common in infant heart surgery and portends a poor clinical outcome.
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Outcome after repair of atrioventricular septal defect with tetralogy of Fallot.
Long-term outcomes of repair of tetralogy of Fallot associated with complete atrioventricular septal defect are seldom reported. We report our survival and reintervention outcomes over a 29-year time period. ⋯ Excellent long-term survival was achieved after repair of tetralogy of Fallot associated with complete atrioventricular septal defect. Palliation and primary repair resulted in comparable outcomes; as such, primary repair is favored. The choice of right ventricular outflow tract reconstruction affects the need for reoperation.
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J. Thorac. Cardiovasc. Surg. · Feb 2012
Preoperative left atrial dysfunction and risk of postoperative atrial fibrillation complicating thoracic surgery.
Postoperative atrial fibrillation complicating general thoracic surgery increases morbidity and stroke risk. We aimed to determine whether preoperative atrial dysfunction or other echocardiographic markers are associated with postoperative atrial fibrillation. ⋯ These data show that an echocardiogram before major thoracic surgery, increased use of preoperative β-blockers, and decreased left atrial emptying fraction were associated with postoperative atrial fibrillation. Echocardiographic predictors of left atrial mechanical dysfunction may prove clinically useful in risk stratifying patients in whom postoperative atrial fibrillation is more likely to develop and to benefit from prevention strategies aimed at mitigating atrial function before surgery.