The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 1999
Comparative StudyDoes the Adamkiewicz artery originate from the larger segmental arteries?
The Adamkiewicz artery supplies most of the blood to the anterior spinal artery, which perfuses the anterior two thirds of the spinal cord. During operations for thoracoabdominal aortic aneurysm, detailed anatomic knowledge of the Adamkiewicz artery and its correlation with the intercostal and/or lumbar arteries is important to prevent postoperative paraplegia. ⋯ This study provides evidence that, during operations on the thoracoabdominal aorta, the intercostal and/or lumbar arteries should be preserved, regardless of their diameter, to prevent postoperative paraplegia.
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J. Thorac. Cardiovasc. Surg. · May 1999
Comparative StudyLong-term outcome after biologic versus mechanical aortic valve replacement in 841 patients.
The purpose of this study was to optimize selection criteria of biologic versus mechanical valve prostheses for aortic valve replacement. ⋯ For first-time, isolated aortic valve replacement, mechanical prostheses should be considered in patients under age 65 years with a life expectancy of at least 10 years. Bioprostheses should be considered in patients over age 65 years or with lung disease (in patients over age 60 years), renal disease, coronary disease, ejection fraction less than 40%, or a life expectancy less than 10 years.
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J. Thorac. Cardiovasc. Surg. · May 1999
Comparative StudyPlatelet anesthesia with nitric oxide with or without eptifibatide during cardiopulmonary bypass in baboons.
This study tested the hypothesis that nitric oxide or nitric oxide and eptifibatide (Integrilin) reversibly inhibit platelet activation and consumption during cardiopulmonary bypass and rapidly restore platelet numbers and function after bypass. ⋯ Nitric oxide with or without eptifibatide protects platelets during cardiopulmonary bypass and accelerates restoration of normal bleeding times after operation in a baboon model. Although nitric oxide and eptifibatide reversibly inhibit platelets by different mechanisms, in the absence of a wound no synergistic effect was demonstrated.