The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyOutcomes of interrupted aortic arch repair using the carotid artery turndown procedure.
Interrupted aortic arch is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease. Multiple surgical modalities exist to address this defect. We evaluate the long-term outcome of interrupted aortic arch with the left carotid artery turndown technique from a single institution. ⋯ Left carotid artery turndown offers a favorable surgical outcome. It compares with end-to-end repair, while providing a tension-free anastomosis and avoiding neonatal circulatory arrest and cardiopulmonary bypass. Disadvantages include a 2-stage repair and a significant reintervention rate, particularly when compared with the aortic arch advancement technique. Nevertheless, the reduced exposure to circulatory arrest and bypass and avoidance of left bronchial obstruction are important considerations that may offset these limitations.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyAsymmetric septal hypertrophy in patients with severe aortic stenosis: the usefulness of associated septal myectomy.
Asymmetric septal hypertrophy frequently coexists with severe aortic stenosis and can be unmasked after successful aortic valve replacement (AVR), jeopardizing the clinical and echocardiographic results. The aim of our study was to investigate, at 5 years postoperatively, the effectiveness of myectomy associated with AVR on left ventricular (LV) mass regression and LV diastolic function. ⋯ Surgeons should inspect the LV outflow tract at AVR. Concomitant myectomy at AVR is a safe and effective procedure that improves LV mass regression and LV diastolic function.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyThe impact of temperature and pump flow rate during selective cerebral perfusion on regional blood flow in piglets.
Ideal temperature and flow rate for selective cerebral perfusion (SCP) are not known. We examined regional organ perfusion in a piglet SCP model. ⋯ SCP at 32°C provides higher brain RBF 2 hours after CPB. Increasing SCP flow rate does not increase RBF significantly at 25°C. Higher temperature during SCP results in improved RBF to the liver and quadriceps.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyPulmonary resections performed at hospitals with thoracic surgery residency programs have superior outcomes.
Pulmonary resections are performed at thoracic residency (TR), general surgery residency (GSR), no surgery residency, and no residency hospitals. We hypothesize that morbidity and mortality for these procedures are different between hospitals and that operations performed at TR teaching hospitals have superior results. ⋯ In comparison with other hospitals, including GSR hospitals, TR hospitals have lower morbidity and mortality. These results support using hospitals with a TR as an independent prognostic indicator of outcomes in pulmonary resections.