The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Successful surgical management of ventricular fibromas in children.
A uniform management strategy has not been established for the treatment of large ventricular fibromas identified in children. The goal of the present study was to review our experience with surgical resection of this uncommon tumor. ⋯ Primary ventricular fibromas, even when very large, can be managed by surgical resection, with excellent short- and intermediate-term ventricular function and relief of arrhythmic events.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Uncovered stent implantation in complicated acute aortic dissection type B.
To retrospectively evaluate the technical feasibility and midterm results of uncovered thoracoabdominal stent placement in complicated acute aortic dissection Stanford type B (cAADB). ⋯ Acute aortic dissection with suspicion of visceral ischemia should prompt for immediate intervention. Thoracoabdominal uncovered stent implantation is a technically feasible and effective minimally invasive approach that provided successful relief of acute visceral ischemia and claudication in cAADB. Stent size should be less than the normal aortic diameter to avoid possible stent collapse.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Targeting survival pathways to create infarct-spanning bridges of human embryonic stem cell-derived cardiomyocytes.
Generating myocyte grafts that bridge across infarcts could maximize their functional impact and best utilize small numbers of stem cells. To date, however, graft survival within acute infarcts has not been feasible. To enhance intrainfarct graft viability, human embryonic stem cell-derived cardiomyocytes (hESC-CMs) were pretreated before implantation with cobalt protoporphyrin (CoPP), a pharmacologic inducer of cytoprotective heme oxygenase-1. ⋯ Cellular therapy delivered acutely after infarction significantly improved postinfarct ventricular function at 1 and 2 months. CoPP pretreatment of cells resulted in stable hESC-CM grafts within infarcted myocardium. This design enables construction of directionally oriented, infarct-spanning bands of new cardiomyocytes that might further improve functional restoration as engrafted myocytes proliferate and mature.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Ventricular and pulmonary vascular remodeling induced by pulmonary overflow in a chronic model of pretricuspid shunt.
Current preclinical models of pulmonary arterial hypertension do not reproduce the clinical characteristics of congenital heart anomalies. Aortocaval shunt is relevant to a variety of clinical conditions. The pathophysiology and possible determination of pulmonary hypertension in this model are still undefined. ⋯ The aortocaval shunt model reliably produces right ventricular volume overload and secondary pulmonary hypertension. Due to a combination of left ventricular dysfunction and pulmonary overflow, the pulmonary hypertension produced shows features similar to those found in patients with chronic atrial-level shunt.