The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Jul 2003
Randomized Controlled Trial Comparative Study Clinical TrialProtection of the human heart with ischemic preconditioning during cardiac surgery: role of cardiopulmonary bypass.
Studies on the effects of ischemic preconditioning in the human heart have yielded conflicting results and therefore remain controversial. This study investigated whether ischemic preconditioning was able to protect against myocardial tissue damage in patients undergoing coronary artery surgery with cardiopulmonary bypass and on the beating heart. ⋯ Ischemic preconditioning is protective in patients undergoing coronary artery surgery on the beating heart without the use of cardiopulmonary bypass, but it offers no additional benefit when associated with bypass regardless of the mode of cardioprotection used, because cardiopulmonary bypass per se induces preconditioning.
-
J. Thorac. Cardiovasc. Surg. · Jul 2003
Comparative StudyPositron emission tomography defines metastatic disease but not locoregional disease in patients with malignant pleural mesothelioma.
Computed tomography and magnetic resonance imaging often fail to predict resectability in patients with malignant pleural mesothelioma. Small studies suggest that fluorodeoxyglucose-positron emission tomography may improve staging. We analyzed our experience to determine more definitively the potential utility of fluorodeoxyglucose-positron emission tomography. ⋯ Positron emission tomography does not identify the local extent of tumor or mediastinal nodal metastases reliably but detects extrathoracic metastases, thereby obviating inappropriate thoracotomy. Further studies of the association between tumor standard uptake value and the presence of N2 disease are warranted.
-
J. Thorac. Cardiovasc. Surg. · Jul 2003
Comparative StudyAn in vitro assessment by means of laser Doppler velocimetry of the medtronic advantage bileaflet mechanical heart valve hinge flow.
The aim of this study was to evaluate the hinge flow field characteristics of the Medtronic Advantage bileaflet valve and compare them with the flow fields of the St Jude Medical standard valve. The present study provides laser Doppler velocimetry results for the Advantage and St Jude Medical valves to make a direct comparison of the flow fields of the 2 valve designs. This study aids in determining the preclinical efficacy of Medtronic's new bileaflet valve hinge design. ⋯ The present study demonstrated that the hinge flow dynamics of the Advantage bileaflet design were similar to those of the St Jude Medical hinge design. The velocities within the hinge were slightly higher for the St Jude Medical valve but not significantly different. There appears to be more dynamic flow through the hinge of the Advantage valve during the forward flow phase.
-
J. Thorac. Cardiovasc. Surg. · Jun 2003
Pulmonary fibrosis and lung cancer: risk and benefit analysis of pulmonary resection.
Pulmonary fibrosis is associated with an increased risk of lung cancer and outcome of surgical resection in this setting is unknown. ⋯ Patients with pulmonary fibrosis undergoing pulmonary resection for non-small cell lung cancer have increased postoperative morbidity and mortality, but an important subgroup has a good long-term outcome. Postoperative acute respiratory distress syndrome is associated with low preoperative gas transfer and a high composite physiological index. Resection of non-small cell lung cancer is appropriate in pulmonary fibrosis, provided that the level of functional impairment is carefully factored into patient selection.