The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Pulmonary hypertension predicts adverse cardiac events after restrictive mitral annuloplasty for severe functional mitral regurgitation.
Pulmonary hypertension (PH) is an indicator of a poor prognosis in patients with dilated cardiomyopathy. Few studies have investigated the prognostic role of PH in patients undergoing restrictive mitral annuloplasty (RMA) for severe functional mitral regurgitation secondary to advanced cardiomyopathy. ⋯ Noninvasive assessment of preoperative PH has a prognostic value in patients undergoing RMA for severe functional mitral regurgitation secondary to advanced cardiomyopathy.
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Review Meta AnalysisIntramyocardial bone marrow stem cell transplantation during coronary artery bypass surgery: a meta-analysis.
Experimental and clinical studies have suggested that intramyocardial bone marrow stem cell transplantation combined with coronary artery bypass grafting might improve left ventricular function in the setting of chronic ischemic heart disease. We therefore conducted a systematic review and meta-analysis of available publications regarding the efficacy and safety of intramyocardial bone marrow stem cell transplantation during coronary artery bypass grafting. ⋯ Clinical evidence suggests that intramyocardial bone marrow stem cell transplantation in combination with coronary artery bypass grafting is associated with improvements of functional parameters in patients with chronic ischemic heart disease. Furthermore, surgical intramyocardial bone marrow stem cell transplantation seems to be safe.
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Late improvement in graft patency after coronary artery bypass grafting: Serial assessment with multidetector computed tomography in the early and late postoperative settings.
Grafts initially showing poor patency after coronary artery bypass grafting have occasionally shown improvement on serial multidetector computed tomography. This study analyzed possible factors associated with this phenomenon. ⋯ A large proportion of radial artery grafts initially showing poor opacification after coronary artery bypass grafting demonstrated patency restoration on serial multidetector computed tomography. Larger target vessel size and target vessel stenosis of at least 90% were significant correlative factors.
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J. Thorac. Cardiovasc. Surg. · Oct 2011
New approach to interstage care for palliated high-risk patients with congenital heart disease.
Home surveillance monitoring might identify patients at risk for interstage death after stage 1 palliation for hypoplastic left heart syndrome. We sought to identify the effect that a high-risk program might have on interstage mortality and identification of residual/recurrent lesions after neonatal palliative operations. ⋯ Initiation of a high-risk program might decrease interstage mortality after high-risk neonatal palliative operations. Such an approach might contribute to earlier detection of significant residual/recurrent lesions amenable to therapy.
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J. Thorac. Cardiovasc. Surg. · Oct 2011
Repair of anomalous origin of the left coronary artery from the pulmonary artery in infants and children.
Although mortality after direct aortic reimplantation for anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) has significantly decreased, many questions remain unanswered. ⋯ Despite the absence of early and late mortality, the long-term prognosis for patients after reimplantation of ALCAPA into the aorta is not clear. Scars and perfusion deficits of the left ventricle may not be detected by standard echocardiographic evaluation of global left ventricular function and therefore may be underestimated. We therefore recommend lifelong surveillance of these patients, including magnetic resonance imaging.