The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Multicenter StudyLong-term functional health status and exercise test variables for patients with pulmonary atresia with intact ventricular septum: a Congenital Heart Surgeons Society study.
A bias favoring biventricular (BV) repair exists regarding choice of repair pathway for patients with pulmonary atresia with intact ventricular septum (PAIVS). We sought to determine the implications of moving borderline candidates down a BV route in terms of late functional health status (FHS) and exercise capacity (EC). ⋯ Late patient-perceived physical FHS and measured EC are reduced, regardless of PAIVS repair pathway, with an important dichotomy whereby patients with PAIVS believe they are doing well despite important physical impediments. For those with smaller initial tricuspid valve z-score, achievement of survival with BV repair may be at a cost of late deficits in exercise capacity, emphasizing that better outcomes may be achieved for borderline patients with a 1.5V- or UV-repair strategy.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Bioengineered human and allogeneic pulmonary valve conduits chronically implanted orthotopically in baboons: hemodynamic performance and immunologic consequences.
This study assesses in a baboon model the hemodynamics and human leukocyte antigen immunogenicity of chronically implanted bioengineered (decellularized with collagen conditioning treatments) human and baboon heart valve scaffolds. ⋯ Valve dysfunction correlated with markers for more intense inflammatory provocation. The tested bioengineering methods reduced antigenicity of both human and baboon valves. Bioengineered replacement valves from both species were hemodynamically equivalent to native valves.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Time in the stair-climbing test as a predictor of thoracotomy postoperative complications.
The stair-climbing test as measured in meters or number of steps has been proposed to predict the risk of postoperative complications. The study objective was to determine whether the stair-climbing time can predict the risk of postoperative complications. ⋯ The only variable showing association with complications, according to multivariate analysis, was stair-climbing time.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Effect of atherothrombotic aorta on outcomes of total aortic arch replacement.
The effect of an atherothrombotic aorta on the short- and long-term outcomes of total aortic arch replacement, including postoperative neurologic deficits, remains unknown. We evaluated this relationship and also elucidated the synergistic effect of multiple other risk factors, in addition to an atherothrombotic aorta, on the neurologic outcome. ⋯ Patients with an atherothrombotic aorta and associated preoperative comorbidities might be predisposed to adverse short- and long-term outcomes, including transient neurologic deficits.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Nebulized nitrite protects rat lung grafts from ischemia reperfusion injury.
Nebulization is a potential method for delivering therapeutic agents to lung grafts. Recent evidence suggests that nitrite may mitigate ischemia-reperfusion injury via a nitric oxide-dependent pathway. ⋯ These data suggest that nebulized nitrite limits lung ischemia-reperfusion injury and may prove a clinically useful strategy but requires appropriate dosing to limit oxidative injury at high doses.