The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 1986
Complications of tracheal reconstruction. Incidence, treatment, and prevention.
Between 1962 and 1982, 416 primary tracheal reconstructions and 21 staged reconstructions were performed. Since then 80 additional tracheal reconstructions have been accomplished (to April of 1985). ⋯ The first and second halves of the series have therefore been compared. Measures to prevent complications are discussed.
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J. Thorac. Cardiovasc. Surg. · Mar 1986
Surgical results for mitral regurgitation from coronary artery disease.
Results of coronary artery bypass grafting with and without mitral valve replacement were analyzed retrospectively in 101 patients with preoperative ischemic mitral regurgitation to determine the effects of severity and surgical treatment of mitral regurgitation on survival. Between 1980 and 1984, a total of 1,475 patients (mean age 59, 77% male) underwent coronary bypass. These patients were divided into three groups: (1) patients without ischemic mitral regurgitation who underwent isolated coronary bypass (1,374; 93%), (2) patients with ischemic mitral regurgitation who underwent isolated coronary bypass without valve replacement (85; 6%), and (3) patients with ischemic mitral regurgitation who underwent combined mitral valve replacement and coronary bypass (16; 1%). ⋯ The actuarial survival rate at 5 years for the coronary bypass patients without ischemic mitral regurgitation was 85% compared to 91% (p less than 0.05) for the coronary bypass patients without ischemic mitral regurgitation. These results indicate that patients with ischemic mitral regurgitation have a higher prevalence of cardiac risk factors and are at an increased risk of operative mortality. Although the severity of the ischemic mitral regurgitation was strongly predictive of early survival, it proved to have an unexpectedly modest effect on long-term survival after surgical treatment.
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J. Thorac. Cardiovasc. Surg. · Feb 1986
Comparative StudyInhibition of pulmonary surfactant by plasma from normal adults and from patients having cardiopulmonary bypass.
Plasma from normal adults and from children and adults having cardiopulmonary bypass inhibited the ability of pulmonary surfactant to reach low surface tension in proportion to the amount of protein added. No increase in the extent of inhibition of surfactant action per milligram of protein was seen in plasma taken before or after bypass in adults or children.
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J. Thorac. Cardiovasc. Surg. · Feb 1986
Case ReportsSubarachnoid-pleural fistula. Case report and review of the literature.
A case is described of a subarachnoid-pleural fistula developing after resection of an intrathoracic benign nerve sheath tumor near the eleventh thoracic vertebra. The fistula was demonstrated by myelography and was corrected surgically. Of 12 previously reported cases, 11 occurred after trauma and one after an operation.
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J. Thorac. Cardiovasc. Surg. · Nov 1985
Anatomic correction for complete transposition and double-outlet right ventricle.
Between February, 1981, and December, 1984, 30 patients underwent anatomic correction of transposition of the great arteries with intact ventricular septum (n = 8), transposition with ventricular septal defect (n = 15), and double-outlet right ventricle with subpulmonary ventricular septal defect, the Taussig-Bing anomaly (n = 7). At operation, ages ranged from 18 hours to 6 years (mean 11.3 months) and weights ranged from 2.6 to 16.4 kg (mean 6.1 kg). The group with transposition and intact ventricular septum on average was younger (mean 1.2 months) and smaller (mean 3.5 kg) than the other two groups. ⋯ Ninety-five percent of the survivors are in New York Heart Association Functional Class I. Postoperative catheterization in 13 patients has shown normal left ventricular function, no coronary stenosis, and no aortic incompetence. Sixty-nine percent of these patients had clinically unsuspected gradients across the right ventricular outflow tract, which may be prevented by avoiding the Lecompte maneuver or the use of conduits.