The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2017
Meta AnalysisA systematic review and meta-analysis of in situ versus composite bilateral internal thoracic artery grafting.
This meta-analysis examines whether there is any advantage of coronary artery bypass graft with bilateral internal thoracic artery (BITA) as an in situ versus composite graft. ⋯ Our meta-analysis found that use of BITA as a composite graft configuration facilitated greater internal thoracic artery revascularization but both grafting strategies offer similar clinical outcomes. Our study supports the use of in situ and composite BITA for select patients but high-quality, long-term prospective trials are needed.
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J. Thorac. Cardiovasc. Surg. · May 2017
Multicenter Study Observational StudyTotal and free cortisol responses and their relation to outcomes after cardiopulmonary bypass in infants.
Hypothalamic-pituitary-adrenal (HPA) axis dysfunction may be partially responsible for the hemodynamic instability experienced by infants after cardiopulmonary bypass (CPB). We report the full spectrum of the HPA response surrounding CPB for infant congenital cardiac surgery. ⋯ We observed a significant decline in all aspects of the HPA axis throughout the first 24 hours after infant CPB. TC and FC levels were not associated with clinical outcomes. Subnormal (Δ <9 μg/dL) TC response to cosyntropin stimulation during the postoperative period was associated with increased fluid resuscitation and greater LOS.
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J. Thorac. Cardiovasc. Surg. · May 2017
Multicenter Study WebcastsExternal stenting: A reliable technique to relieve airway obstruction in small children.
Airway obstruction in children may be caused by conditions such as vascular compression and congenital tracheobronchomalacia. Obstructive pulmonary vascular disease may be a detrimental sequel for patients with congenital heart disease. We evaluate our own original external stenting technique as a treatment option for these patients. ⋯ External stenting is a reliable method to relieve airway compression for small children, allowing an age-proportional growth of the airway.