European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Feb 2013
Long-term results of the arterial switch operation for ventriculo-arterial discordance.
The arterial switch operation (ASO) has become the standard surgical procedure for transposition of the great arteries (TGA) or variants with an excellent early outcome. However, there are concerns regarding neopulmonary stenosis, neoaortic regurgitation (neoAR) associated with neoaortic root dilatation and coronary artery disease. ⋯ The survival and functional outcomes of the ASO were excellent in the long-term. Strict serial surveillance is required to evaluate the long-term functional outcome of the ASO, particularly in a high-risk anatomy.
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Eur J Cardiothorac Surg · Feb 2013
State of the art in paediatric heart transplantation: the Berlin experience.
Enormous progress has been made in paediatric heart transplantation since the first unsuccessful effort by Kantrowitz in 1967. Early reports of children undergoing heart transplantation showed alarmingly high perioperative mortality rates of 25-60%, with the diagnosis of congenital heart disease (CHD) representing a particularly high-risk subset compared with cardiomyopathy. Many of these early failures were related to poor patient selection, suboptimal immunosuppression and technical problems. ⋯ The disparity between the demand for and supply of donor hearts makes retransplantation an ethical issue. We 'do not refuse' any patient who needs retransplantation. Mechanical circulatory support devices for long-term use are now largely available to accommodate such cases.
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Eur J Cardiothorac Surg · Feb 2013
Acute type A aortic dissection: long-term results and reoperations.
The objective of this study was to report long-term results and incidence of reoperations after surgery for acute type A dissection. ⋯ Acute type A dissection in the current era is associated with a decreasing acceptable operative mortality risk and has a satisfactory long-term survival for hospital survivors. These factors were both involved were associated with a lower 30-day mortality. A substantial proportion of patients will require reoperations on the aortic valve or the aorta.
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Eur J Cardiothorac Surg · Feb 2013
Cysteinyl leukotriene receptor antagonist montelukast ameliorates acute lung injury following haemorrhagic shock in rats.
The aim of this study was to assess the possible protective effect of montelukast against haemorrhagic shock-induced acute lung injury by interfering with inflammatory and oxidative pathways. Acute lung injury following haemorrhagic shock/resuscitation is an important contributor to late morbidity and mortality in trauma patients. Haemorrhagic shock (HS), followed by resuscitation, is considered to be an insult that frequently induces systemic inflammatory response syndrome and oxidative stress, resulting in multiple-organ dysfunction syndrome, including microvascular changes and microscopic damage termed acute lung paraynchymal injury. Montelukast is a cysteinyl leukotriene receptor antagonist that exerts an anti-inflammatory and antioxidant influence. ⋯ The results of the present study reveal that montelukast may ameliorate lung injury in shocked rats by interfering with inflammatory and oxidative pathways, implicating the role of leukotrienes in the pathogenesis of haemorrhagic shock-induced lung inflammation.