The Annals of thoracic surgery
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Randomized Controlled Trial
Early donor management increases the retrieval rate of lungs for transplantation.
Lung transplantation activity is frustrated by donor lung availability. We sought to examine the effect of active donor management and hormone administration on pulmonary function and yield in cadaveric heart-beating potential lung donors. ⋯ Early active management of lung donors increases yield. Steroid administration reduces progressive lung water accumulation.
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Septal myectomy is the gold-standard therapy for hypertrophic obstructive cardiomyopathy (HOCM). However, it is being challenged by a less-invasive alternative: alcohol septal ablation. This study examined the clinical effectiveness and risks of isolated septal myectomy for HOCM. ⋯ Isolated septal myectomy is effective in eliminating LVOT obstruction and sudden death and in improving functional status, with low operative morbidity and mortality. Few reoperations are required late and outcomes are excellent. It should be considered the treatment of choice for HOCM.
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Cardiopulmonary exercise (CPX) testing may identify patients at high risk of postoperative cardiopulmonary morbidity and mortality. This study aims to assess the utility of CPX testing before esophagectomy. ⋯ Although the VO2peak was significantly lower in those patients who developed cardiopulmonary complications, CPX testing is of limited value in predicting postoperative cardiopulmonary morbidity in patients undergoing esophagectomy.
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Randomized Controlled Trial
Ventilation during cardiopulmonary bypass: impact on cytokine response and cardiopulmonary function.
A complex inflammatory response associated with the use of cardiopulmonary bypass may ultimately lead to organ dysfunction. We investigate the effect of continuing ventilation during cardiopulmonary bypass on inflammatory reactions and cardiopulmonary function. ⋯ Continued ventilation during cardiopulmonary bypass results in lesser inflammatory and proteolytic responses, and may better preserve pulmonary function than cardiopulmonary bypass without ventilation.