The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Comparative StudyRight ventricular free wall stress after tricuspid valve annuloplasty in acute ovine right heart failure.
Tricuspid annuloplasty rings may have a direct impact on right ventricular shape and free wall stress, potentially affecting chamber remodeling and recurrent regurgitation. In an acute model of ovine right heart failure, we investigated right ventricular free wall stress after annuloplasty with different prostheses. ⋯ Acute right heart failure significantly increased right ventricular free wall stress, which was normalized with equal efficacy by all studied prostheses. Chronic studies are needed to evaluate long-term effects of annuloplasty rings on right ventricle free wall stress and remodeling.
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Return to intended oncologic treatment after surgery for malignant pleural mesothelioma.
Trimodality therapy may prolong survival for patients with resectable malignant pleural mesothelioma. However, many patients are unable to complete therapy. We sought to identify risk factors for failing to complete adjuvant intensity-modulated radiation therapy after cytoreduction for malignant pleural mesothelioma. ⋯ Many patients are unable to complete adjuvant intensity-modulated radiation therapy after cytoreduction. Failure to complete adjuvant intensity-modulated radiation therapy was associated with worse preoperative comorbidity, but not the type of surgery or margin status.
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Transcriptome profiling reveals activation of inflammation and apoptosis in the neonatal striatum after deep hypothermic circulatory arrest.
Brain injury, leading to long-term neurodevelopmental deficits, is a major complication in neonates undergoing cardiac surgeries. Because the striatum is one of the most vulnerable brain regions, we used mRNA sequencing to unbiasedly identify transcriptional changes in the striatum after cardiopulmonary bypass and associated deep hypothermic circulatory arrest. ⋯ Our study provides a comprehensive view of global transcriptional changes in the striatum after deep hypothermic circulatory arrest and found strong activation of both inflammatory and apoptotic signaling pathways in the deep hypothermic circulatory arrest group. Nuclear factor-kB, a key driver of inflammation, appears to be an upstream regulator of the majority of the upregulated genes; hence, nuclear factor-kB inhibitors could potentially be tested for beneficial effects on neurologic outcome.
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J. Thorac. Cardiovasc. Surg. · Sep 2019
Measuring chordae tension during transapical neochordae implantation: Toward understanding objective consequences of mitral valve repair.
Complex structure of mitral valve and its central position in the heart limit assessment of mitral function to standardized calculated parameters assessed using medical imaging (echocardiography). Novel techniques, which allow mitral valve repair (MVr) in a beating heart, offer the opportunity for innovative objective assessment in physiologic and pathologic conditions. We report, to our knowledge, the first data of real-time chordal tension measurement during a transapical neochordae implantation. ⋯ The tension applied on chordae during transapical implantation of neochordae for degenerative mitral regurgitation can be measured, providing original data about the objective consequences of MVr on the mitral apparatus.