The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Safety and Feasibility of Adjunct Autologous Cord Blood Stem Cell Therapy During the Norwood Heart Operation.
We conducted this phase I, open-label safety and feasibility trial of autologous cord blood (CB) stem cell (CBSC) therapy via a novel blood cardioplegia-based intracoronary infusion technique during the Norwood procedure in neonates with an antenatal diagnosis of hypoplastic left heart syndrome (HLHS). CBSC therapy may support early cardiac remodeling with enhancement of right ventricle (RV) function during the critical interstage period. ⋯ This trial demonstrated that autologous CBMNCs delivered in large numbers without prior cryopreservation via a novel intracoronary infusion technique at cardioplegic arrest during Norwood palliation on days 2 to 3 of life is feasible and safe.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Identification of regional variation in gene expression and inflammatory proteins in donor lung tissue and ex vivo lung perfusate.
Diagnosing lung injury is a challenge in lung transplantation. It has been unclear if a single biopsy specimen is truly representative of the entire organ. Our objective was to investigate lung inflammatory biomarkers using human lung tissue biopsies and ex vivo lung perfusion perfusate. ⋯ Cytokine gene expression in lung biopsies was consistent, and the biopsy analysis reflects the whole lung, except when specimens were collected from the lingula or an area of focal injury. Ex vivo lung perfusion perfusate also provides a representative measurement of lung inflammation from the draining lobe. These results will reassure clinicians that a lung biopsy or an ex vivo lung perfusion perfusate sample can be used to inform donor lung selection.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Papillary Muscle Approximation in Chronic Ovine Functional Tricuspid Regurgitation.
Isolated tricuspid ring annuloplasty remains the surgical standard for functional tricuspid regurgitation repair but offers suboptimal results when right ventricular dilation and remodeling along with papillary muscle displacement is present. Addressing subvalvular remodeling with papillary muscle approximation may improve clinical outcomes. ⋯ Papillary muscle approximations were effective in reducing severe ovine functional tricuspid regurgitation associated with right ventricular dilation and papillary muscle displacement. Further studies are needed to evaluate efficacy of this adjunct to ring annuloplasty in repair of severe functional tricuspid regurgitation.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Natural History of Aortic Root Dilatation and Pathologic Aortic Regurgitation in Tetralogy of Fallot and its Morphological Variants.
We sought to characterize the natural history of aortic root dilatation and aortic regurgitation in tetralogy of Fallot (TOF). ⋯ Patients with TOF-variant are at comparatively greater risk of pathologic root dilatation over time, warranting closer longitudinal follow-up.
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J. Thorac. Cardiovasc. Surg. · Dec 2023
Statistical power and sample size calculations for time-to-event analysis.
To provide thoracic and cardiovascular surgeons with the necessary tools for performing sample size and power calculations for studies with time-to-event outcomes. ⋯ Statistical power is an essential element for designing studies to ensure sufficient sample sizes for detecting treatment effects or group differences in time-to-event patient outcomes. Power and sample size justification not only adds statistical rigor and credibility to research manuscripts, but also provides the reader with assurance that the findings and conclusions are valid and based on a sufficient number of patients.