The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 1998
Randomized Controlled Trial Clinical TrialModified ultrafiltration improves left ventricular systolic function in infants after cardiopulmonary bypass.
Our objective was to test the hypothesis that use of modified ultrafiltration after cardiopulmonary bypass improves intrinsic left ventricular systolic function in children. ⋯ Use of modified ultrafiltration after cardiopulmonary bypass improves intrinsic left ventricular systolic function, improves diastolic compliance, increases blood pressure, and decreases inotropic drug use in the early postoperative period.
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J. Thorac. Cardiovasc. Surg. · Feb 1998
Controlled reperfusion after lung ischemia: implications for improved function after lung transplantation.
Despite improvements in organ preservation, reperfusion injury remains a major source of morbidity and mortality after lung transplantation. This pilot study was designed to investigate the effects of controlled reperfusion after lung ischemia. ⋯ After 2 hours of warm pulmonary ischemia, (1) a severe lung injury occurs after uncontrolled reperfusion, (2) controlled reperfusion with either a modified reperfusion solution or white blood cell filter limits, but does not avoid, a lung reperfusion injury, (3) reperfusion using both a modified reperfusate and white blood cell filter results in complete preservation of pulmonary function. We therefore believe surgeons should control the reperfusate after lung transplantation to improve postoperative pulmonary function.
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J. Thorac. Cardiovasc. Surg. · Feb 1998
Modified ultrafiltration versus conventional ultrafiltration: a randomized prospective study in neonatal piglets.
Cardiopulmonary bypass in neonates generates large increases in inflammatory mediators, causing edema formation that may lead to multiple organ dysfunction. Clinical strategies aimed at removing inflammatory mediators, reducing edema formation, and improving organ function include conventional and modified ultrafiltration. ⋯ Modified ultrafiltration is superior to conventional ultrafiltration and no filtration in reducing the total body weight gain, lessening myocardial edema, raising mean arterial pressure, and improving left ventricular contractility in neonatal piglets undergoing cardiopulmonary bypass and cardioplegic arrest.
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J. Thorac. Cardiovasc. Surg. · Feb 1998
Aortic valve replacement with cryopreserved aortic allograft: ten-year experience.
Cryopreserved aortic allograft can be used for aortic valve replacement in congenital, rheumatic, degenerative, and infected native valve conditions, as well as failed prosthetic valves. This study was conducted to determine the long-term results of aortic valve replacement with cryopreserved aortic allografts. ⋯ Aortic valve replacement with cryopreserved aortic allografts can be performed with low perioperative and long-term mortality. Most patients have excellent functional status, and reoperation for valve-related causes is unusual. Aortic valve replacement with cryopreserved aortic allografts demonstrates excellent freedom from thromboembolism, endocarditis, and progressive valve incompetence.
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J. Thorac. Cardiovasc. Surg. · Jan 1998
Clinical TrialLeft ventricular dysfunction after open repair of simple congenital heart defects in infants and children: quantitation with the use of a conductance catheter immediately after bypass.
Quantification of myocardial injury after the simplest pediatric operations by load-independent indices of left ventricular function, using conductance and Mikro-Tip pressure catheters (Millar Instruments, Inc., Houston, Tex.) inserted through the left ventricular apex. ⋯ Load-independent indices of left ventricular function can be derived from left ventricular pressure-volume loops generated by conductance and Mikro-Tip pressure catheters during the perioperative period in infants and children undergoing cardiac operations. Incomplete myocardial protection was demonstrated by a deterioration in systolic function after even short bypass and crossclamp times.