The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Sep 2003
Randomized Controlled Trial Comparative Study Clinical TrialNeuropsychometric outcome following aortic arch surgery: a prospective randomized trial of retrograde cerebral perfusion.
Aortic surgery requiring hypothermic circulatory arrest is associated with a high incidence of brain injury. However, knowledge of neuropsychometric outcome is limited. Retrograde cerebral perfusion has become a popular adjunctive technique to hypothermic circulatory arrest. The aim of this study was to assess neuropsychometric outcome and compare the 2 techniques. ⋯ Hypothermic circulatory arrest plus/minus retrograde cerebral perfusion is associated with a high incidence of neuropsychometric change despite ostensibly normal clinical outcomes and apparently safe arrest duration. Retrograde cerebral perfusion did not improve outcome in this small study.
-
Spontaneous pneumomediastinum usually occurs in young people without an apparent precipitating factor or disease. Thoracic surgeons are involved in the diagnosis and management of this entity because of the potentially life-threatening conditions that either must be treated as an emergency or excluded, such as esophageal perforation or necrotizing mediastinitis. We present our modest experience in treating spontaneous pneumomediastinum. ⋯ Spontaneous pneumomediastinum is usually an undiagnosed benign entity that responds very well to conservative treatment. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults.
-
J. Thorac. Cardiovasc. Surg. · Sep 2003
Complication of benign tracheobronchial strictures by self-expanding metal stents.
Self-expanding metal stents are used to palliate benign strictures. We examined the complications of this approach. ⋯ The current generation of self-expanding metal stents should be avoided in benign strictures of trachea and bronchi.
-
J. Thorac. Cardiovasc. Surg. · Sep 2003
The influence of mechanical properties on wall stress and distensibility of the dilated ascending aorta.
We sought to determine how intrinsic mechanical properties of dilated ascending aorta influence in vivo distensibility and wall stress, potential contributing factors to the risk of aortic rupture and dissection. ⋯ The age dependence of elastic properties of dilated ascending aorta is consistent with that of normal aorta observed in previous studies. Increases in mean circumferential stress with blood pressure and diameter support the clinical importance of blood pressure control and serial evaluation of aortic diameter. Declining wall strength with age may increase the risk of rupture or dissection.