The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2005
Comparative StudyTime-resolved three-dimensional magnetic resonance velocity mapping of aortic flow in healthy volunteers and patients after valve-sparing aortic root replacement.
To provide more complete characterization of ascending aortic blood flow, including vortex formation behind the valve cusps, in healthy subjects and patients after valve-sparing aortic root replacement (David reimplantation). ⋯ Coronary cusp vorticity was preserved after David reimplantation, regardless of neosinus creation. Increased retrograde flow and helicity were more prominent in T. David-V patients. These novel magnetic resonance imaging methods can assess the clinical implications of altered aortic flow dynamics in patients undergoing various types of valve-sparing aortic root replacement.
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J. Thorac. Cardiovasc. Surg. · Aug 2005
Comparative StudyA comparison of transit-time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass graft patency.
Intraoperative graft patency assessment during coronary artery bypass grafting enables detection and immediate correction of graft failure. Currently transit-time flowmetry is used to assess graft patency on the basis of mean graft flow and derived values, such as the pulsatility index. Intraoperative fluorescence imaging, based on the fluorescence of indocyanine green dye, provides direct visual images to confirm graft patency. ⋯ In most patients, both intraoperative fluorescence imaging and transit-time flowmetry are useful to confirm intraoperative graft patency. However, in a small proportion of patients (10%), graft patency assessment with transit-time flowmetry alone might prompt unnecessary graft revision.
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J. Thorac. Cardiovasc. Surg. · Aug 2005
Differential cardiac gene expression during cardiopulmonary bypass: ischemia-independent upregulation of proinflammatory genes.
Cardiac surgery with cardiopulmonary bypass induces both systemic and local inflammatory responses implicated in the pathogenesis of myocardial dysfunction. Multifactorial perioperative sources of myocardial injury complicate understanding of the molecular mechanisms involved. By using microarray technology, this study examines myocardial gene expression responses to cardiopulmonary bypass in the absence of cardioplegic arrest and ischemia-reperfusion injury. ⋯ This study represents an initial report on the use of microarray technology to elucidate cardiac transcriptional programs in response to cardiopulmonary bypass-specific injury in vivo. These preliminary findings, combined with future functional genomic studies superimposing ischemia and reperfusion and other inflammatory stimuli, should improve our understanding of the molecular regulatory networks involved in myocardial responses to injury and aid in the development of novel cardioprotective and perfusion strategies.
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J. Thorac. Cardiovasc. Surg. · Aug 2005
Assumed oxygen consumption frequently results in large errors in the determination of cardiac output.
We sought to investigate the differences in assumed and measured oxygen consumption values for the determination of cardiac output by using the Fick principle in a pediatric population with congenital heart disease. ⋯ The use of assumed instead of measured oxygen consumption values introduces large errors in the determination of cardiac output.