The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Effect of anterior strut chordal transection on the force distribution on the marginal chordae of the mitral valve.
Transection of the secondary chordae on the anterior leaflet of the mitral valve to relieve leaflet tethering and reduce regurgitation is an experimentally proven procedure to correct functional mitral regurgitation. In the present study, we sought to investigate whether transecting the secondary chordae would have an effect on the marginal chordal force on the same leaflet. ⋯ The increase in the marginal chordal force after secondary chordal cutting depends on the location of the papillary muscles and the extent of leaflet tethering. Although chordal cutting might not alter the valve mechanics under minimal leaflet tethering, it significantly affects the mechanics when the leaflet tethering is more pronounced, which is typically seen in patients with functional mitral regurgitation.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Nadir hematocrit during cardiopulmonary bypass: end-organ dysfunction and mortality.
To discover the effects of the lowest hematocrit during cardiopulmonary bypass on end-organ function and mortality in patients who did not receive red blood cell transfusion and to identify predictors of nadir hematocrit. ⋯ Although red blood cell transfusion has associated morbidity risk, there must be a tradeoff between adverse effects of low hematocrit during cardiac surgery and those of transfusion. The strong association of nadir hematocrit with preoperative hematocrit suggests the need for investigation and optimization before elective cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Uniquely shaped cardiovascular stents enhance the pressure generation of intravascular blood pumps.
Advances in the geometric design of blood-contacting components are critically important as the use of minimally invasive, intravascular blood pumps becomes more pervasive in the treatment of adult and pediatric patients with congestive heart failure. The present study reports on the evaluation of uniquely shaped filaments and diffuser blades in the development of a protective stent for an intravascular cavopulmonary assist device for patients with a single ventricle. ⋯ The specialized design of the stents, which protect the vessel wall from the rotating components of the pump, proved to be advantageous by further augmenting the pressure generation of the pump, reducing the flow vorticity at the pump outlet, and enhancing flow control.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Extracorporeal membrane oxygenation as a bridge to lung transplantation and recovery.
Respiratory failure develops in many patients on lung transplant waiting lists before a suitable donor organ becomes available. Extracorporeal membrane oxygenation may be used to bridge such patients to recovery or lung transplantation. ⋯ Extracorporeal membrane oxygenation is a safe and effective means of bridging well-selected patients with refractory respiratory failure to lung transplantation or return to their baseline condition.
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J. Thorac. Cardiovasc. Surg. · Sep 2012
Review Case ReportsTrue aneurysm of anterior mitral leaflet--a rare entity.