The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Endovascular repair of aortic arch lesions in high-risk patients or after previous aortic surgery: midterm results.
The aim of this study was to assess the short- and midterm results after endovascular repair of the aortic arch in high-risk patients or after previous aortic surgery. ⋯ Hybrid endovascular aortic arch reconstructions, although some of these adjunctive procedures remain major operations, provide attractive alternatives for treating aortic arch lesions in high-risk patients who would otherwise be unsuitable for open repair, with acceptable primary results and encouraging midterm efficacy to prevent rupture.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Effect of beta-blocker use on outcomes after discharge in patients who underwent cardiac surgery.
Beta-blockers improve outcomes in patients with heart failure or a history of myocardial infarction, but it remains uncertain whether they are beneficial after the perioperative period in cardiac surgery patients without these conditions. This study was designed to examine whether discharge use of beta-blockers was associated with outcomes after hospitalization in patients who had undergone nontransplant cardiac surgery. ⋯ Patients discharged with beta-blockers after cardiac surgery exhibit a substantially lower mortality rate during long-term follow-up, even among those without a history of myocardial infarction or heart failure.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Patent ductus arteriosus ligation is associated with impaired left ventricular systolic performance in premature infants weighing less than 1000 g.
Patent ductus arteriosus ligation is often complicated by systemic hypotension and oxygenation failure. The ability of the immature myocardium to compensate for altered afterload is poorly understood. The aim of this study was to characterize the effects of patent ductus arteriosus ligation on myocardial performance in preterm infants. ⋯ Patent ductus arteriosus ligation is sometimes associated with impaired left ventricular systolic performance, which is most likely attributable to altered loading conditions. Neonates weighing 1000 g or less are at increased risk of impaired left ventricular systolic performance, which might relate to maturational differences and decreased tolerance to altered loading conditions.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Mortality after coronary artery revascularization of patients with rheumatoid arthritis.
Patients with rheumatoid arthritis have an increased risk for accelerated atherosclerosis. It is not known, however, whether this disorder is associated with a higher risk of complications after coronary artery revascularization. ⋯ Among patients undergoing coronary artery revascularization, patients with rheumatoid arthritis have an in-hospital survival advantage along with reduced days of hospitalization compared with patients without rheumatoid arthritis.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Risk factor analysis for postoperative acute respiratory distress syndrome and early mortality after pneumonectomy: the predictive value of preoperative lung perfusion distribution.
This study aims to establish the preoperative risk factors in the development of acute respiratory distress syndrome (ARDS) and early mortality after pneumonectomy for lung cancer and to examine the influence of reduced pulmonary perfusion on outcomes. ⋯ Patients with a low ppo-FEV(1), a high perfusion fraction of resected lung, or both had a higher incidence of ARDS and early mortality after pneumonectomy. Therefore, although the ppo-FEV(1) appears to be within an acceptable limit for pneumonectomy, much attention should be given to patients with a high perfusion fraction of resected lung.