The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2008
Extracorporeal circulation by peripheral cannulation before redo sternotomy: indications and results.
Cardiac reoperations are challenging and time-consuming, and have a high risk for reentry injuries. We discuss the indications, advantages, and technologic features of cardiopulmonary bypass by peripheral cannulation before resternotomy. ⋯ In selected patients, cardiopulmonary bypass before resternotomy is a valid and reproducible option to render cardiac reoperations safer and more expeditious in the reentry phase. The absence of cannulae in the operating field makes the procedure more comfortable. The liberal use of this strategy is recommended in redo cases.
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J. Thorac. Cardiovasc. Surg. · Sep 2008
Evolving arch surgery using integrated antegrade selective cerebral perfusion: impact of axillary artery perfusion.
The study objective was to determine the impact of integrated antegrade selective cerebral perfusion with right axillary artery perfusion during arch surgery. ⋯ Right axillary artery perfusion is an advantageous adjunct to cardiopulmonary bypass and antegrade selective cerebral perfusion in arch surgery.
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J. Thorac. Cardiovasc. Surg. · Aug 2008
Surgery for rheumatic tricuspid valve disease: a 30-year experience.
This study was undertaken to assess factors influencing short- and long-term outcomes of surgery for rheumatic disease of the tricuspid valve. ⋯ Organic tricuspid valve disease associated with rheumatic mitral or aortic lesions increases hospital and late mortality, but valve repair compared favorably with valve replacement. Long-term results may be considered acceptable for otherwise incurable valve disease.
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J. Thorac. Cardiovasc. Surg. · Aug 2008
Comparative StudyUse of mathematic modeling to compare and predict hemodynamic effects of the modified Blalock-Taussig and right ventricle-pulmonary artery shunts for hypoplastic left heart syndrome.
Stage one reconstruction (Norwood operation) for hypoplastic left heart syndrome can be performed with either a modified Blalock-Taussig shunt or a right ventricle-pulmonary artery shunt. Both methods have certain inherent characteristics. It is postulated that mathematic modeling could help elucidate these differences. ⋯ The close correlation between predicted and observed data supports the use of mathematic modeling in the design and assessment of surgical procedures. The potentially damaging effects of a systemic ventriculotomy in the right ventricle-pulmonary artery shunt modification of the Norwood operation have not been analyzed.
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J. Thorac. Cardiovasc. Surg. · Aug 2008
Randomized Controlled Trial Comparative StudyA prospective randomized comparison of the Medtronic Advantage Supra and St Jude Medical Regent mechanical heart valves in the aortic position: is there an additional benefit of supra-annular valve positioning?
The aim of this prospective randomized trial was to evaluate the impact of complete supraannular positioning of mechanical aortic bileaflet valves. ⋯ By grouping the data on the basis of a patient's tissue annulus diameter, no significant superiority of either prosthesis was detected with regard to left ventricular mass regression, effective orifice area index, and mean pressure gradient during rest and exercise. We conclude that there is no additional benefit of supraannular valve positioning.