The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2020
Randomized Controlled TrialSingle-dose cardioplegia protects myocardium as well as traditional repetitive dosing: A noninferiority randomized study.
The present prospective noninferiority randomized trial was designed to demonstrate the safety and efficacy of a single dose of Custodiol histidine-tryptophan-ketoglutarate compared with repetitive cold-blood cardioplegia. ⋯ A single dose of Custodiol histidine-tryptophan-ketoglutarate cardioplegia is not inferior to repeated cold-blood cardioplegia during elective cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · May 2020
Defining the role of adjuvant therapy for early-stage large cell neuroendocrine carcinoma.
Large cell neuroendocrine carcinoma is a rare, high-grade neuroendocrine tumor. The mainstay of treatment for early, node-negative disease is surgical resection, and optimal adjuvant treatment strategies are not well defined. ⋯ In this national study of early-stage large cell neuroendocrine carcinoma, AC was associated with significantly longer survival for tumors larger than 3 cm, and possibly for tumors 2 to 3 cm. Adjuvant radiation was not associated with prolonged survival.
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J. Thorac. Cardiovasc. Surg. · May 2020
Observational StudyEffect of β-blocker therapy on late outcomes after surgical repair of type A aortic dissection.
The objective of the study was to evaluate the effects of β-blocker therapy on long-term outcomes in patients after surgical repair of type A aortic dissection. ⋯ β-Blocker usage had a protective effect on long-term outcomes in patients after surgical repair of acute type A aortic dissection. Strict medication adherence of β-blocker therapy was associated with a survival benefit.
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J. Thorac. Cardiovasc. Surg. · May 2020
Delayed delivery of endothelial progenitor cell-derived extracellular vesicles via shear thinning gel improves postinfarct hemodynamics.
Extracellular vesicles (EVs) are promising therapeutics for cardiovascular disease, but poorly-timed delivery might hinder efficacy. We characterized the time-dependent response to endothelial progenitor cell (EPC)-EVs within an injectable shear-thinning hydrogel (STG+EV) post-myocardial infarction (MI) to identify when an optimal response is achieved. ⋯ Delivery of STG+EV 4 days post-MI improved left ventricular contractility and preserved global ventricular geometry, compared with controls and immediate therapy post-MI. These findings suggest other cell-derived therapies can be optimized by strategic timing of therapeutic intervention.