The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2010
Review Meta AnalysisEffect of statins on atrial fibrillation after cardiac surgery: a duration- and dose-response meta-analysis.
This meta-analysis of randomized, controlled trials evaluated effects of statins on postoperative atrial fibrillation risk after cardiac surgery. ⋯ Evidence suggests that statins are associated with reduced risk of postoperative atrial fibrillation and shorter hospital stay after cardiac surgery and that earlier therapy results in more profound benefit.
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J. Thorac. Cardiovasc. Surg. · Aug 2010
Activation of A1, A2A, or A3 adenosine receptors attenuates lung ischemia-reperfusion injury.
Adenosine and the activation of specific adenosine receptors are implicated in the attenuation of inflammation and organ ischemia-reperfusion injury. We hypothesized that activation of A(1), A(2A), or A(3) adenosine receptors would provide protection against lung ischemia-reperfusion injury. ⋯ Selective activation of A(1), A(2A), or A(3) adenosine receptors provides significant protection against lung ischemia-reperfusion injury. The decreased elaboration of the potent proinflammatory cytokine tumor necrosis factor-alpha and decreased neutrophil sequestration likely contribute to the overall improvement in pulmonary function. These results provide evidence for the therapeutic potential of specific adenosine receptor agonists in lung transplant recipients.
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J. Thorac. Cardiovasc. Surg. · Aug 2010
Repair of regurgitant bicuspid aortic valves: a systematic approach.
Patients with bicuspid aortic valves can present with aortic insufficiency caused by cusp disease or the aortic root pathology. We present our 13-year experience with a functional and systematic approach to bicuspid aortic valve repair. ⋯ A systematic approach to bicuspid aortic valve repair yields good early and midterm results. Repair of bicuspid valves for aortic insufficiency is a feasible and attractive alternative to mechanical valve replacement in young patients.
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J. Thorac. Cardiovasc. Surg. · Aug 2010
Randomized Controlled Trial Comparative StudyCefazolin bolus and continuous administration for elective cardiac surgery: improved pharmacokinetic and pharmacodynamic parameters.
Cefazolin (1-2 g bolus at induction possibly repeated after cardiopulmonary bypass) remains the standard for antibiotic prophylaxis in cardiac surgery. Data indicate, however, that it is underdosed with this dosing schedule. A prospective, randomized study comparing intermittent versus loading dose plus continuous infusion for the same total dose of cefazolin was performed to assess which modality is pharmacokinetically and pharmacodynamically advantageous. ⋯ Administration of cefazolin as bolus plus continuous infusion has pharmacokinetic and pharmacodynamic advantages relative to intermittent administration. It provides more stable serum levels, lower interpatient variability, and higher myocardial tissue penetration.
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J. Thorac. Cardiovasc. Surg. · Aug 2010
Randomized Controlled Trial Comparative StudyCryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions.
Forceps biopsy is the standard method to obtain specimens in endoscopically visible lesions. It is common to combine forceps biopsy with cytology methods to increase the diagnostic yield. Although the flexible cryoprobe has been established for bronchoscopic interventions in malignant stenosis, the obtained biopsies, called "cryobiopsies," have not been investigated in a large cohort of patients. The aim of this feasibility study was to prospectively evaluate the diagnostic yield and safety of cryobiopsy and forceps biopsy. ⋯ Cryobiopsy is safe and increases the diagnostic yield in endobronchial tumor lesions. The method also is feasible under routine conditions.