The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2003
The influence of mechanical properties on wall stress and distensibility of the dilated ascending aorta.
We sought to determine how intrinsic mechanical properties of dilated ascending aorta influence in vivo distensibility and wall stress, potential contributing factors to the risk of aortic rupture and dissection. ⋯ The age dependence of elastic properties of dilated ascending aorta is consistent with that of normal aorta observed in previous studies. Increases in mean circumferential stress with blood pressure and diameter support the clinical importance of blood pressure control and serial evaluation of aortic diameter. Declining wall strength with age may increase the risk of rupture or dissection.
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J. Thorac. Cardiovasc. Surg. · Aug 2003
Comparative StudyEarly and late stroke after mitral valve replacement with a mechanical prosthesis: risk factor analysis of a 24-year experience.
We evaluated risk factors for mortality and stroke after mechanical mitral valve replacement between May 1977 and December 2001. ⋯ Persistent atrial fibrillation was the most significant risk factor for late stroke after mechanical mitral valve replacement. Restoration of sinus rhythm with a maze procedure nearly eliminated the risk of late stroke, whereas neither closure of the left atrial appendage nor therapeutic anticoagulation prevented this complication.
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J. Thorac. Cardiovasc. Surg. · Aug 2003
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialImpact of sodium-hydrogen exchange inhibition by cariporide on death or myocardial infarction in high-risk CABG surgery patients: results of the CABG surgery cohort of the GUARDIAN study.
To evaluate the effects of cariporide on all-cause mortality or myocardial infarction at 36 days in patients at risk of myocardial necrosis after coronary artery bypass graft surgery. ⋯ Clinical benefit with cariporide 120 mg was observed early after treatment initiation and continued for 6 months postsurgery, suggesting that sodium-hydrogen exchange inhibition with cariporide is cardioprotective in patients undergoing high-risk coronary artery bypass graft surgery.
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J. Thorac. Cardiovasc. Surg. · Aug 2003
Comparative StudyThe prognostic significance of intranodal isolated tumor cells and micrometastases in patients with non-small cell carcinoma of the lung.
To study whether isolated tumor cells and micrometastases, as defined by the current American Joint Committee on Cancer criteria for extrapulmonary neoplasms, have prognostic value for patients with resected non-small cell carcinoma of the lung. ⋯ Patients with non-small cell carcinoma of the lung with isolated tumor cells and pN1mi have similar survivals to those with pN0, consistent with the findings reported for breast cancer patients. Future larger studies of patients with non-small cell carcinoma of the lung are needed to confirm whether current American Joint Committee on Cancer staging criteria should be modified to include the pN1mi category.
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J. Thorac. Cardiovasc. Surg. · Aug 2003
Comparative StudySurvival benefit of lung transplantation for patients with idiopathic pulmonary fibrosis.
Although lung transplantation is viewed as an acceptable option for patients with end-stage idiopathic pulmonary fibrosis, the survival benefit of this approach is still debated. This study examined whether there was a survival benefit of lung transplantation in a cohort of patients referred to our transplant center with a diagnosis of idiopathic pulmonary fibrosis according to American Thoracic Society criteria. ⋯ Lung transplantation is effective in improving the survival of selected patients affected by idiopathic pulmonary fibrosis.