The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Sealing of pulmonary arteries with LigaSure: in vivo and ex vivo examinations.
The LigaSure device has been demonstrated to be safe for systemic vessels up to 7 mm in diameter, although its use in thoracic surgery remains understudied. We aimed to evaluate the safety of LigaSure for pulmonary artery sealing. ⋯ LigaSure does not result in complete fusion of the wall layers of pulmonary arteries. The pulmonary artery burst pressure after sealing is significantly less compared with conventional suture ligation. It remains unclear whether these findings create a clinical risk of rupture.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Diabetes mellitus and the metabolic syndrome do not abolish, but might reduce, the cardioprotective effect of ischemic postconditioning.
Ischemic preconditioning fails to protect the diabetic heart against lethal reperfusion injury. Because the pathways of ischemic pre- and postconditioning partially overlap, we evaluated the cardioprotective effect of ischemic postconditioning in mouse models of type 2 diabetes (ObOb) and the metabolic syndrome (DKO). ⋯ The cardioprotective effect of ischemic postconditioning was sustained in C57BL/6J mice after 10 weeks and protected against adverse left ventricular remodeling. In mouse models of type 2 diabetes, protection against lethal reperfusion injury is present, leading to increased survival after ischemia and reperfusion.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Fetal cardiac intervention: improved results of fetal cardiac bypass in immature fetuses using the TinyPump device.
Fetal cardiac surgery is a potential innovative treatment for certain congenital heart defects that have significant mortality and morbidity in utero or after birth, but it has been limited by placental dysfunction after fetal cardiac bypass. We have used the TinyPump device for fetal cardiac bypass in sheep fetuses at 90 to 110 days gestation. ⋯ We demonstrate the feasibility of the TinyPump device for fetal cardiac bypass in a fetal sheep model. The TinyPump group showed improved results compared with the roller head group despite more immature fetuses. The TinyPump device seems to be a promising device for future studies of fetal cardiac bypass in immature fetal sheep and in primates.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
New ascending aortic aneurysm model in rats reproduces main structural features of degenerative ascending thoracic aortic aneurysms in human beings.
The singularity of the ascending aorta regarding mechanisms driving aneurysm formation requires the development of specific animal models. We investigated if adventitial elastase application results in ascending aorta aneurysms in rats. ⋯ Elastase application on rat ascending aortic adventitia produced aneurysms, creating a reproducible model. Aortic wall remodeling evolved toward an increase in total wall area, reproducing the main structural features of this disease in human beings.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Significance of force transfer in mitral valve-left ventricular interaction: in vivo assessment.
The objective of this study was to assess the combined force transfer from the papillary muscle tips to the mitral valve through the chordae tendineae in vivo, and thereby quantify the force transmitted through the papillary-chordal complex to augment left ventricular ejection. ⋯ This study is the first to assess the magnitude and time course of the longitudinal force transmitted through the papillary-chordal complex to the left ventricular wall during ejection. The study also demonstrates a significant force transfer to the closing force acting on the mitral valve leaflets that constitutes an essential component of valvular-ventricular interaction to enhance left ventricular systolic pump performance. The magnitude of the combined papillary muscle force component emphasizes the crucial role of preserving mitral valve-left ventricular continuity in mitral valve surgery.