The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · May 2020
Optimized mitral annuloplasty ring design reduces loading in the posterior annulus.
The study objective was to develop a novel annuloplasty ring with regional flexibility and assess its suture force dynamics in healthy ovine subjects compared with fully rigid or fully flexible rings. ⋯ The reduced FC of the heterogeneous ring relative to the fully rigid ring suggests a promising approach to reduce suture loading while preserving the annular remodeling capability of fully rigid rings. Future studies in diseased subjects are necessary to explore repair effectiveness of this ring.
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J. Thorac. Cardiovasc. Surg. · May 2020
Effects of genetic transfection on calcium cycling pathways mediated by double-stranded adeno-associated virus in postinfarction remodeling.
Restoring calcium sensor protein (S100A1) activity in failing hearts poses a promising therapeutic strategy. We hypothesize that cardiac overexpression of the S100A1 gene mediated by a double-stranded adeno-associated virus (scAAV) results in better functional and molecular improvements compared with the single-stranded virus (ssAAV). ⋯ Gene therapy of S100A1 can prevent pathologic postmyocardial infarction remodeling and decrease inflammatory response in ischemic heart failure.
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J. Thorac. Cardiovasc. Surg. · May 2020
Prognostic influence of tumor microenvironment after hypofractionated radiation and surgery for mesothelioma.
Cytotoxic CD8+ tumor infiltrating lymphocytes (TILs) can contribute to the benefit of hypofractionated radiation, but programmed cell death pathways (programmed cell death 1 and programmed cell death ligand 1 [PD-1/PD-L1]) may provide a mechanism of tumor immune escape. We therefore reviewed the influence of PD-1/PD-L1 and CD8+ TILs on survival after accelerated hypofractionated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma (MPM). ⋯ The influence of tumor microenvironment on survival differs between epithelioid and nonepithelioid MPM. CD8+ TILs is an independent factor associated with better survival in epithelioid MPM treated with SMART.
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J. Thorac. Cardiovasc. Surg. · May 2020
Comparative StudyOpen surgery and endovascular repair for mycotic aortic aneurysms: Benefits beyond survival.
Endovascular techniques have been increasingly used to treat mycotic aortic aneurysms. However, apart from survival, the potential benefits of open surgery and endovascular repair for mycotic aortic aneurysms are poorly understood. The aim of this study was to evaluate the short- and mid-term outcomes after open surgery versus endovascular repair for mycotic aortic aneurysms. ⋯ There were no significant differences between endovascular repair and open surgery in survival. However, in the mid-term, the potential benefits of open surgery are favorable compared with endovascular repair, including lower infection-related reoperation rates and reduced medical burden.
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J. Thorac. Cardiovasc. Surg. · May 2020
Serial cardiac magnetic resonance imaging after surgical coronary revascularization for left ventricular dysfunction.
Serial changes in segmental myocardial function after surgical myocardial revascularization have not been well demonstrated. This study was conducted to evaluate improvements in segmental myocardial function after coronary artery bypass grafting in patients with left ventricular dysfunction. ⋯ One third of segments with a transmural extent of LGE >50% still had a chance for improvement after revascularization, although an inverse correlation was seen between the LGE grade and improvement of segmental myocardial function.