European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jun 2019
Randomized Controlled TrialCan human myocardium be remotely preconditioned? The results of a randomized controlled trial.
No experimental study has shown that the myocardium of a remotely preconditioned patient is more resistant to a standardized ischaemic/hypoxic insult. ⋯ NCT01994707.
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Eur J Cardiothorac Surg · Jun 2019
Observational StudyAcquired von Willebrand syndrome in paediatric patients during mechanical circulatory support.
Bleeding signs can become life-threatening complications in patients on mechanical circulatory support (MCS). Clinical phenotyping and comprehensive analyses of the cause of bleeding are, therefore, essential, especially when risk-stratifying patients during MCS workup. We conducted coagulation analyses and determined von Willebrand factor (VWF) parameters in a paediatric cohort on temporary extracorporeal life support, extracorporeal membrane oxygenation or long-term ventricular assist device support. ⋯ The AVWS prevalence in paediatric patients on MCS is 100% regardless of the types of devices tested in this study. The bleeding propensity of AVWS patients widely varies.
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Eur J Cardiothorac Surg · Jun 2019
Observational StudySilent cerebral infarction after thoracic endovascular aortic repair: a magnetic resonance imaging study.
Silent cerebral infarction is the most common brain injury incidentally detected on imaging and can be associated with increased risks of future stroke and cognitive decline. However, the incidence and risk factors of silent cerebral infarction after thoracic endovascular aortic repair (TEVAR) for aortic arch pathologies remain unclear. This study aimed to examine silent cerebral infarction following TEVAR using diffusion-weighted (DW) magnetic resonance imaging (MRI). ⋯ The incidence of silent cerebral infarction following TEVAR with supra-aortic debranching for aortic arch pathologies was 21%, and the severity of atheromatous change in the aortic arch, especially in the proximal landing zone, was positively associated with the development of silent cerebral infarction.
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Eur J Cardiothorac Surg · Jun 2019
Case ReportsIncorrect frozen elephant trunk deployment into the false lumen of a patient with complicated type B acute dissection.
Total arch replacement with frozen elephant trunk (FET) is used for type B acute aortic dissection with insufficient proximal landing zone. Herein, we report incorrect deployment of FET into the false lumen. A 45-year-old man underwent femorofemoral bypass for complicated type B acute aortic dissection. ⋯ Progressive lactic acidosis occurred on postoperative day 2, and computed tomography showed incorrect deployment of the FET into the false lumen, causing true lumen stenosis and intestinal ischaemia. Despite extensive enterectomy and abdominal aorta fenestration for the improvement of true lumen perfusion, the patient died of multiorgan failure on postoperative day 7. Care is required to avoid incorrect deployment of FET when there is a large entry in the proximal descending aorta.