The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2011
Decellularization reduces immunogenicity of sheep pulmonary artery vascular patches.
Allograft vascular tissue is important in the repair of complex structural lesions of the heart and great vessels, but induces a deleterious immune response that might shorten the effective lifespan of the tissue and sensitize the recipient. We hypothesized that decellularizing allograft vascular tissue reduces the host allogeneic immune response. ⋯ Decellularization of allograft vascular tissue minimized the recipient cellular immune response and eliminated the production of anti-donor antibodies in recipients.
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J. Thorac. Cardiovasc. Surg. · Apr 2011
Myocardial function after fetal cardiac bypass in an ovine model.
Fetal cardiac surgery might improve the prognosis of certain complex congenital heart defects that have significant associated mortality and morbidity in utero or after birth. An important step in translating fetal cardiac surgery is identifying potential mechanisms leading to myocardial dysfunction after bypass. The hypothesis was that fetal cardiac bypass results in myocardial dysfunction, possibly because of perturbation of calcium cycling and contractile proteins. ⋯ Fetal cardiac bypass was associated with myocardial dysfunction and disruption of calcium cycling and contractile proteins. Minimizing myocardial dysfunction after cardiac bypass is important for successful fetal surgery to repair complex congenital heart defects.
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J. Thorac. Cardiovasc. Surg. · Apr 2011
Early reperfusion with warm, polarizing adenosine-lidocaine cardioplegia improves functional recovery after 6 hours of cold static storage.
Rewarming and reanimating the donor heart from cold static storage predisposes the organ to injury and graft dysfunction. Our main aim was to investigate the effects of 5 minutes of continuous rewarming with a normokalemic, oxygenated, polarizing adenosine-lidocaine arrest solution after 6 hours of cold static storage (4°C) in adenosine-lidocaine or Celsior (Genzyme Corp, Cambridge, Mass) solutions. ⋯ Rewarming the rat heart after cold static storage in polarizing adenosine-lidocaine arrest solution resulted in significantly higher aortic flow, coronary flow, and cardiac output compared with that seen after Krebs-Henseleit or Celsior rewarming. Rewarming cold Celsior hearts with adenosine-lidocaine solution reduced stunning. Adenosine-lidocaine cardioplegia might offer a new reperfusion strategy after cold static storage.
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J. Thorac. Cardiovasc. Surg. · Mar 2011
Thromboresistant surfaces with low-dose anticoagulation alleviate clopidogrel-related complications in patients undergoing coronary artery bypass grafting.
Numerous studies have shown that, when using conventional perfusion methodology, patients undergoing coronary artery bypass grafting within 7 days of receiving clopidogrel are at increased risk of bleeding, re-exploration, and blood transfusion. The purpose of this study was to evaluate the effect of clopidogrel administration before coronary artery bypass grafting on patients using thromboresistant surfaces with low-dose heparin during surgical intervention. ⋯ Hemostatic complications related to clopidogrel exposure within 5 days before an isolated coronary artery bypass grafting operation can be alleviated by the application of a biocompatible perfusion strategy using low-dose heparin in conjunction with a closed thromboresistant circuit.