The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2016
Salusin-β contributes to vascular inflammation associated with pulmonary arterial hypertension in rats.
Inflammation is closely linked to pulmonary arterial hypertension (PAH). Salusin-β, a bioactive peptide, has been reported to participate in vascular inflammation. We therefore hypothesized that salusin-β contributes to monocrotaline (MCT)-induced PAH in rats. ⋯ Salusin-β plays a crucial role in the development of MCT-induced PAH models.
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J. Thorac. Cardiovasc. Surg. · Oct 2016
Survival status and functional outcome of children who required prolonged intensive care after cardiac surgery.
Children who require prolonged intensive care after cardiac surgery are at risk of high mortality. The long-term survival and functional outcome of these children have not been studied in detail. ⋯ The incidence of children requiring prolonged intensive care after cardiac surgery has increased in our institution. Our data suggest that the long-term outcome for most of these children is poor, especially after univentricular repair.
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J. Thorac. Cardiovasc. Surg. · Oct 2016
Performance of allogeneic bioengineered replacement pulmonary valves in rapidly growing young lambs.
Cardiac allometric organ growth after pediatric valve replacement can lead to patient-prosthesis size mismatch and valve re-replacement, which could be mitigated with allogeneic decellularized pulmonary valves treated with collagen conditioning solutions to enhance biological and mechanical performance, termed "bioengineered valves." In this study, we evaluated functional, dimensional, and biological responses of these bioengineered valves compared with traditional cryopreserved valves implanted in lambs during rapid somatic growth. ⋯ Biological valve conduits can enlarge via passive dilatation without matrix synthesis, but this would result in decreased cusp coaptational areas. Bioengineered valves demonstrated similar annulus enlargement as cryopreserved valves but usually retained larger areas of cuspal coaptation. Heat-shock protein 47-positive (collagen-synthesizing) cells were present in previously acellular bioengineered sinus walls and cusp bases, but rarely in more distal cusp matrices.
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J. Thorac. Cardiovasc. Surg. · Oct 2016
A modified technique of laryngotracheal reconstruction without the need for prolonged postoperative stenting.
Repair of laryngotracheal stenosis with pronounced side-to-side narrowing and involvement of the glottis is challenging and usually requires laryngotracheal reconstruction with rib cartilage interpositions. This technique, as first described by Couraud, needs prolonged postoperative stabilization with Montgomery T-tubes, imposing significant morbidity and discomfort on patients. We describe our initial experience with a modified laryngotracheal reconstruction technique that avoids the need for prolonged postoperative stenting. ⋯ We conclude that this modified technique of laryngotracheal reconstruction represents a valid treatment option for patients with complex glottosubglottic stenosis, avoiding the need for prolonged postoperative stenting.
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J. Thorac. Cardiovasc. Surg. · Oct 2016
Cerebral oxygen delivery is reduced in newborns with congenital heart disease.
To investigate preoperative cerebral hemodynamics in newborns with congenital heart disease. We hypothesized that cerebral blood flow and oxygen delivery would be decreased in newborns with congenital heart disease compared with controls. ⋯ Newborns with unrepaired cyanotic congenital heart disease have decreased cerebral oxygen delivery due to arterial desaturation. If brain growth and development are adversely affected through oxygen conformance, our findings could have clinical implications in terms of timing of surgical repair.