J Cardiothorac Surg
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J Cardiothorac Surg · May 2017
Randomized Controlled TrialA randomized comparison of flow characteristics of semiskeletonized and pedicled internal thoracic artery preparations in coronary artery bypass.
Harvesting the internal thoracic artery (ITA) with semiskeletonization is an alternative technique between conventional wide pedicle and skeletonization. It is almost as simple as pedicle harvesting; however, it is supposed to provide the advantage of graft flow and length. Since the heart is unique being the only organ which is perfused during diastole, for comparing the intraoperative graft flow characteristics of semiskeletonization and pedicle technique, we used diastolic filling (DF) using transit-time flow measurement as a primary result. The objective of this study is to compare if semiskeletonized ITA has a greater effect on the intraoperative DF of graft flow versus conventional pedicled ITA in coronary artery bypass. ⋯ Semiskeletonized ITA resulted in superior DF of left anterior descending bypass graft flow as compared with pedicled ITA. It is also provide a greater free flow and length of the graft without the long-delayed operative time.
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J Cardiothorac Surg · Apr 2017
Clinical TrialHeartmate 3 fully magnetically levitated left ventricular assist device for the treatment of advanced heart failure -1 year results from the Ce mark trial.
The HeartMate 3 Left Ventricular Assist System (LVAS) (St. Jude Medical Inc., St Paul, MN) with full magnetic levitation allows for wide and consistent blood flow paths and an artificial pulse designed for enhanced hemocompatibility. The HeartMate 3 received market approval in the European Union in 2015 following completion of a multicenter study. After reaching the 6-month study endpoint, patients continue to be followed for 2 years with the 1-year results presented herein. ⋯ The 1-year HeartMate 3 LVAS results show survival and adverse-event profile are similar to other approved devices, with no pump thrombosis or pump failure. Patient's functional status and quality of life significantly improved over time.
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J Cardiothorac Surg · Mar 2017
Case ReportsA rare case report of early bioprosthetic valve thrombosis presenting with acute heart failure salvaged by thrombectomy.
Bioprosthetic valve thrombosis is previously considered as an extremely rare complication which hasn't been systemically recognized and understood. ⋯ Our study reviews predisposing factors, typical echocardiographic features and treatment for bioprosthetic valve thrombosis and it should be considered as a reason for bioprosthetic malfunction. A combination of clinical and echocardiographic features can help for diagnosis preoperatively. In some certain circumstances, early reoperation can be avoided if anticoagulant therapy works.
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J Cardiothorac Surg · Jan 2017
Continuous paravertebral block using a thoracoscopic catheter-insertion technique for postoperative pain after thoracotomy: a retrospective case-control study.
Thoracic epidural analgesia (EDA) is the gold standard for pain control after thoracotomy. However, because of its severe side effects, it is contraindicated in patients taking anticoagulant or antiplatelet drugs. In addition, some patients' anatomy can make epidural catheter insertion challenging. We therefore investigated the safety and efficacy of paravertebral block (PVB) using a thoracoscopic insertion technique, which avoids damage to the parietal pleura, for postoperative pain after thoracotomy. ⋯ Under the conditions of the present study, continuous thoracic PVB was at least as effective as epidural analgesia for postoperative pain control after thoracotomy with lung resection.
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J Cardiothorac Surg · Jan 2017
Postoperative air leak grading is useful to predict prolonged air leak after pulmonary lobectomy.
Results of studies to predict prolonged air leak (PAL; air leak longer than 5 days) after pulmonary lobectomy have been inconsistent and are of limited use. We developed a new scale representing the amount of early postoperative air leak and determined its correlation with air leak duration and its potential as a predictor of PAL. ⋯ This simple new method to predict PAL using SUM4to9 showed that the amount of early postoperative air leak is the most powerful predictor of PAL, therefore, grading air leak after pulmonary lobectomy is a useful method to predict PAL.