The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyDilation of the pulmonary autograft after the Ross procedure.
Dilation of pulmonary autograft after the Ross procedure is being recognized with increasing frequency. This study was undertaken to examine the extent of this problem and factors that may be associated with it. ⋯ Dilation of the pulmonary autograft after the Ross procedure may occur because of an intrinsic abnormality of the pulmonary root in patients with congenital aortic valve disease. The technique of aortic root replacement is associated with a higher risk of dilation of the sinuses of Valsalva and sinotubular junction than the technique of aortic root inclusion.
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyResults of Norwood stage I operation: comparison of hypoplastic left heart syndrome with other malformations.
We compared the Norwood stage I operation for hypoplastic left heart syndrome and other complex malformations with ductus-dependent systemic circulation. ⋯ The survival of patients with malformations other than hypoplastic left heart syndrome after the Norwood procedure is greater than for those with hypoplastic left heart syndrome. Staged palliation is valid surgical therapy in these patients, with good results in intermediate follow-up.
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyEvaluation and outcome of different surgical techniques for postintubation tracheoesophageal fistulas.
We evaluated the outcome of different surgical techniques for postintubation tracheoesophageal fistula. ⋯ Postintubation tracheoesophageal fistula is usually best treated with tracheal or laryngotracheal resection and anastomosis with primary esophageal closure even in the absence of tracheal damage.
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyRegional low-flow perfusion provides cerebral circulatory support during neonatal aortic arch reconstruction.
Because of concerns regarding the effects of deep hypothermia and circulatory arrest on the neonatal brain, we have developed a technique of regional low-flow perfusion that provides cerebral circulatory support during neonatal aortic arch reconstruction. ⋯ Regional low-flow perfusion is a safe and simple bypass management technique that provides cerebral circulatory support during neonatal aortic arch reconstruction. The reduction of deep hypothermia and circulatory arrest time required may reduce the risk of cognitive and psychomotor deficits.
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyEliminating the cervical esophagogastric anastomotic leak with a side-to-side stapled anastomosis.
Although the acute postoperative complications of a cervical esophagogastric anastomosis are less than those with an intrathoracic esophageal anastomosis, the long-term sequelae of a cervical anastomotic leak are not as minor as initially reported. Nearly 50% of cervical anastomotic leaks result in an anastomotic stricture, and the subsequent need for chronic dilatations negates the merits of an operation intended to restore comfortable swallowing. ⋯ Construction of the cervical esophagogastric anastomosis with a side-to-side stapled anastomosis greatly reduces the frequency of anastomotic leaks and later strictures. The side-to-side stapled anastomosis is a major technical advance in the progression of refinements of transhiatal esophagectomy and a cervical esophagogastric anastomosis.