The Annals of thoracic surgery
-
We describe a technique of mini-thoracotomy to plicate the paralyzed hemidiaphragm with thoracoscopic assistance. Most of the hemidiaphragm can be plicated expeditiously under direct vision with light derived from a posterior thoracoscope placed in the auscultatory triangle. Videoscopic vision is employed only occasionally when the view of the posteromedial hemidiaphragm is obscured. Continuous suture traction can be easily applied through the mini-thoracotomy, thus maintaining suture tension and enabling maximal inversion of the elevated hemidiaphragm.
-
A new technique of video-assisted thoracic sympathectomy through retrosternal pulmonary junction can be done safely using a scope guide and a flexible scope. Bilateral thoracic sympathectomy was performed, employing a single skin incision, in 18 patients with palmar hyperhidrosis. The advantages include minimal neuralgia and superior cosmesis.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Antegrade/retrograde cardioplegia for valve replacement: a prospective study.
From 1994 to 1996, 75 patients undergoing valve replacement were randomized to antegrade (36 patients, group 1) or antegrade/retrograde (39 patients, group 2) administration of cold blood cardioplegia. ⋯ Our study shows no significant advantage of the antegrade/retrograde administration of cardioplegia over the antegrade route in routine valvular replacement, other than a slightly shorter aortic cross-clamping time.
-
Randomized Controlled Trial Clinical Trial
Inhibitory effect of milrinone on cytokine production after cardiopulmonary bypass.
It has been suggested that cyclic adenosine monophosphate-elevating agents suppress cytokine production. To evaluate the effects of milrinone, a phosphodiesterase III inhibitor, on cytokine production after cardiopulmonary bypass, we conducted a prospective randomized study. ⋯ The results indicate that milrinone suppresses cytokine production by elevating cyclic adenosine monophosphate levels in patients undergoing cardiopulmonary bypass. With its positive inotropic and vasodilator activities, milrinone may have antiinflammatory effects.