The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyThe impact of temperature and pump flow rate during selective cerebral perfusion on regional blood flow in piglets.
Ideal temperature and flow rate for selective cerebral perfusion (SCP) are not known. We examined regional organ perfusion in a piglet SCP model. ⋯ SCP at 32°C provides higher brain RBF 2 hours after CPB. Increasing SCP flow rate does not increase RBF significantly at 25°C. Higher temperature during SCP results in improved RBF to the liver and quadriceps.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance.
At present, there is no consensus on the optimal strategy for follow-up care after curative resection for lung cancer. We sought to understand the patterns of recurrence and second primary lung cancer, and their mode of detection, after resection for early-stage non-small cell lung cancer in patients who were followed by routine surveillance computed tomography scan. ⋯ Almost all second primary cancers and the majority of recurrences were detected by post-therapeutic surveillance computed tomography scan. The risk of recurrence for early-stage non-small cell lung cancer survivors persisted during the first 4 years after resection, and vigilance in surveillance should be maintained.
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The purpose of the present study was to evaluate the association of open and closed Fontan fenestration status with event-free survival. ⋯ Fenestration closure was associated with greater arterial oxygen saturation but not greater event-free survival. The interval to an event was slightly less than the interval to fenestration closure, suggesting potential merit in the evaluation of earlier fenestration closure. Adoption of specific fenestration management guidelines might help improve the overall outcomes and enhance the quality of future studies.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Performance evaluation of a pediatric viscous impeller pump for Fontan cavopulmonary assist.
The anatomic and physiologic constraints for pediatric cavopulmonary assist differ markedly from adult Fontan circulations owing to smaller vessel sizes and risk of elevated pulmonary resistance. In this study, hemodynamic and hemolysis performance of a catheter-based viscous impeller pump (VIP) to power the Fontan circulation is assessed at a pediatric scale (∼15 kg) and performance range (0-30 mm Hg). ⋯ A VIP will augment Fontan cavopulmonary flow in the proper pressure and flow ranges, with low hemolysis risk under more stringent pediatric scale and physiology compared with adult scale. This technology may be developed to simultaneously reduce systemic venous pressure and improve cardiac output after stage 2 or 3 Fontan repair. It may serve to compress surgical staging, lessening the pathophysiologic burden of repair.