The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Randomized Controlled Trial Comparative StudyThe effects of normoxic versus hyperoxic cardiopulmonary bypass on oxidative stress and inflammatory response in cyanotic pediatric patients undergoing open cardiac surgery: a randomized controlled trial.
This study investigates the effects of controlled reoxygenation cardiopulmonary bypass on oxidative stress, inflammatory response, and organ function in children undergoing repair of cyanotic congenital heart defects. ⋯ Controlled reoxygenation on starting cardiopulmonary bypass is associated with reduced myocardial damage, oxidative stress, and cerebral and hepatic injury compared with hyperoxic bypass and similar whole body inflammatory and stress response in cyanotic children undergoing open cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Jul 2009
A new de-airing technique that reduces systemic microemboli during open surgery: a prospective controlled study.
We have evaluated a new technique of cardiac de-airing that is aimed at a) minimizing air from entering into the pulmonary veins by opening both pleurae and allowing lungs to collapse and b) flushing out residual air from the lungs by staged cardiac filling and lung ventilation. These air emboli are usually trapped in the pulmonary veins and may lead to ventricular dysfunction, life-threatening arrhythmias, and transient or permanent neurologic deficits. ⋯ The de-airing technique evaluated in this study is simple, reproducible, controlled, safe, and effective. Moreover, it is cost-effective because the de-airing time is short and no extra expenses are involved.
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Comparative StudyComparison of radial artery patency according to proximal anastomosis site: direct aorta to radial artery anastomosis is superior to radial artery composite grafting.
The radial artery is frequently the second graft of choice after the left internal thoracic artery in coronary artery bypass graft surgery. However, the optimal radial artery proximal anastomosis site remains controversial. The aim of the present study was to compare the radial artery patency according to its use as either an aorta-radial artery graft or composite radial artery graft in coronary artery bypass grafting. ⋯ The results of the current data showed superior early and late patency rates of coronary artery bypass grafting with radial artery to aorta anastomosis compared with left internal thoracic artery-radial artery composite grafting.
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J. Thorac. Cardiovasc. Surg. · Jul 2009
Signal transducer and activator of transcription 3-stimulated hypoxia inducible factor-1alpha mediates estrogen receptor-alpha-induced mesenchymal stem cell vascular endothelial growth factor production.
Vascular endothelial growth factor, a critical factor in angiogenesis, mediates stem cell paracrine protective effects on ischemic myocardium. Studies on the role of sex in stem cell function have demonstrated that female mesenchymal stem cells produce greater vascular endothelial growth factor and provide better cardiac protection compared with male mesenchymal stem cells. The purpose of this study was to determine the mechanisms by which estrogen affects mesenchymal stem cell function as a potential therapeutic measure during ex vivo expansion, before therapeutic use. ⋯ 17beta-estradiol-induced vascular endothelial growth factor production from mesenchymal stem cells appears to be mediated through estrogen receptor-alpha-activated signal transducer and activator of transcription 3-mediated hypoxia inducible factor-1alpha expression.