Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2014
Case ReportsOver 1200-day support with dual Jarvik 2000 biventricular assist device.
We report the successful longest biventricular support using dual Jarvik 2000 biventricular assist device (BVAD; Jarvik Heart, Inc., New York, NY, USA) as a bridge to transplant. A 27-year old woman with arrhythmogenic right ventricular cardiomyopathy underwent implantation of two Jarvik 2000s as a left ventricular assist device and right ventricular assist device. ⋯ Despite advances in continuous-flow ventricular assist devices, their long-term use for biventricular support remains limited. We report a successful case of 1245 days of biventricular support with dual Jarvik 2000 axial flow pumps in a patient with a small body surface area.
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Interact Cardiovasc Thorac Surg · Dec 2014
Case ReportsElephant trunk in a small-calibre true lumen for chronic aortic dissection: cause of haemolytic anaemia?
The elephant trunk technique for aortic dissection is useful for reducing false lumen pressure; however, a folded vascular prosthesis inside the aorta can cause haemolysis. The purpose of this study was to investigate whether an elephant trunk in a small-calibre lumen can cause haemolysis. ⋯ A folded elephant trunk in a small-calibre lumen can cause haemolysis. Therefore, inserting an elephant trunk in a small-calibre true lumen during surgery for chronic aortic dissection should be avoided.
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Interact Cardiovasc Thorac Surg · Dec 2014
Controlled lung reperfusion to reduce pulmonary ischaemia/reperfusion injury after cardiopulmonary bypass in a porcine model.
Ischaemia/reperfusion (I/R) injury of the lungs contributes to pulmonary dysfunction after cardiac surgery with cardiopulmonary bypass (CPB), leading to increased morbidity and mortality of patients. This study investigated the value of controlled lung reperfusion strategies on lung ischaemia-reperfusion injury in a porcine CPB model. ⋯ Controlled lung reperfusion strategies attenuated a decrease in lung mechanics and an increase in oxidative stress, indicating an influence on CPB-related pulmonary injury. However, they failed to avoid completely CPB-related lung injury, implying the need for additional strategies given the multifactorial pathophysiology of postoperative pulmonary dysfunction.
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Interact Cardiovasc Thorac Surg · Dec 2014
The results of a two-stage double switch operation for congenital corrected transposition of the great arteries with a deconditioned morphologically left ventricle.
The purpose of this retrospective study was to evaluate a two-stage double switch operation, morphological left ventricular (mLV) retraining followed by an atrial-arterial switch operation, in the management of patients with congenitally corrected transposition of the great arteries (CCTGA) and a deconditioned mLV. ⋯ For CCTGA children with degraded mLV, the two-stage double switch procedure can be performed with low mortality and morbidity and may be an appealing alternative to conventional repair. mLV retraining should be performed as early as possible. The second-stage atrial-arterial switch procedure showed satisfactory early and mid-term results. More attention should be paid to the long-term function of the mLV and the aortic valve.