The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2002
Long-term administration of nicorandil abolishes ischemic and pharmacologic preconditioning of the human myocardium: role of mitochondrial adenosine triphosphate-dependent potassium channels.
Acute administration of mitochondrial adenosine triphosphate-dependent potassium channel openers preconditions the heart, but whether their long-term administration induces a permanent state of protection is unknown. These studies investigate the effect of long-term treatment with the mitochondrial adenosine triphosphate-dependent potassium channel opener nicorandil on the response of the human myocardium to ischemia and preconditioning. ⋯ The myocardium of patients chronically treated with nicorandil cannot be preconditioned either by ischemia or pharmacologically, and this is because of unresponsive mitochondrial adenosine triphosphate-dependent potassium channels. However, protection can be obtained by protein kinase C and p38 mitogen-activated protein kinase activation, which are downstream of mitochondrial adenosine triphosphate-dependent potassium channels in the signaling transduction pathway of preconditioning.
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J. Thorac. Cardiovasc. Surg. · Oct 2002
Inelastic vascular prosthesis for proximal aorta increases pulsatile arterial load and causes left ventricular hypertrophy in dogs.
Elastic property of the proximal aorta plays an important role in reducing pulsatile load to the ventricle. When a stiff vascular prosthesis is used for the proximal aorta, the pulsatile load increases. We designed this study to elucidate whether the increase in pulsatile load caused left ventricular hypertrophy. ⋯ Since there was no increase in arterial resistance, we conclude that the increase in pulsatile load was the cause of left ventricular hypertrophy. A stiff vascular prosthesis used for the proximal aorta may cause left ventricular hypertrophy.
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J. Thorac. Cardiovasc. Surg. · Sep 2002
Comparative StudyImpact of Cox maze procedure on outcome in patients with atrial fibrillation and mitral valve disease.
We sought to determine whether the Cox maze procedure provides additional benefit to patients with atrial fibrillation undergoing mitral valve operations. ⋯ The addition of the Cox maze procedure to mitral valve repair and replacement was safe and effective for selected patients. Elimination of atrial fibrillation significantly decreased the incidence of late stroke.
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J. Thorac. Cardiovasc. Surg. · Sep 2002
Comparative StudyImproved outcomes in coronary artery bypass grafting with beating-heart techniques.
Although improved outcomes for selected patients by elimination of cardiopulmonary bypass have been demonstrated, a benefit for all patients undergoing coronary artery bypass grafting by all surgeons has yet to be definitively proved. ⋯ Beating-heart surgery can be safely assimilated into a cardiac surgical practice, although adoption rates vary significantly among individual surgeons. Gradual integration can lead to improved outcomes in the total coronary artery bypass surgery population.