The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Feb 2002
Benefits of prophylactic continuous infusion of furosemide after the maze procedure for atrial fibrillation.
One of the most significant complications seen after the maze procedure for atrial fibrillation is excessive fluid retention, with subsequent pulmonary complications. To address this problem we recently started treating all patients prophylactically with a continuous infusion of furosemide starting immediately after the operation. ⋯ Despite a smaller total dose relative to bolus infusion, prophylactic continuous furosemide infusion decreased the adverse pulmonary complications associated with excessive fluid retention in patients undergoing the maze procedure for atrial fibrillation.
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J. Thorac. Cardiovasc. Surg. · Jan 2002
Delivery of a non-potassium modified maintenance solution to enhance myocardial protection in stressed neonatal hearts: a new approach.
This study was undertaken to compare conventional cardioplegic strategies with a new approach that uses a modified non-potassium maintenance solution between cardioplegia doses in stressed neonatal hearts. ⋯ Infusion of a cold modified solution between cardioplegic doses (modified integrated protection) significantly improved myocardial protection in the stressed neonatal heart, was effective delivered either antegradely or retrogradely, and was used successfully for hypoxic (stressed) pediatric patients.
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J. Thorac. Cardiovasc. Surg. · Jan 2002
Use of extracorporeal membrane oxygenation in pediatric thoracic organ transplantation.
Mechanical cardiorespiratory support is occasionally required before or after pediatric thoracic organ transplantation. Extracorporeal membrane oxygenation is the most commonly used mechanical support technique in children. The goal of this study was to examine the indications for initiation and outcomes after peritransplant use of extracorporeal membrane oxygenation. ⋯ Long-term outcomes among those undergoing heart transplantation after support with an extracorporeal membrane oxygenator are comparable with those of patients not receiving extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation can be a useful post-transplant support device, particularly in patients undergoing lung transplants.
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J. Thorac. Cardiovasc. Surg. · Jan 2002
Fractal or biologically variable delivery of cardioplegic solution prevents diastolic dysfunction after cardiopulmonary bypass.
To determine whether myocardial protection is improved by restoring physiologic variability to the cardioplegia pressure signal during cardiopulmonary bypass, we compared cardiac function in pigs in the first hour after either conventional cold-blood cardioplegia (group CC) or computer-controlled biologically variable pulsatile cardioplegia (group BVC). ⋯ Diastolic cardiac function is better preserved after cardiopulmonary bypass with biologically variable pulsatile cardioplegia and fractal perfusion. This may be attributed to enhanced microcirculatory perfusion with improved myocardial protection. A model supporting these results is presented.
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J. Thorac. Cardiovasc. Surg. · Jan 2002
One-year appraisal of a new aortic root conduit with sinuses of Valsalva.
We evaluate the clinical results 1 year after an anatomic reconstruction of the aortic root in which we used a specifically designed aortic root prosthesis that incorporates the sinuses of Valsalva. ⋯ The new aortic root prosthesis allowed the reconstruction of the aortic root anatomy in all types of surgical techniques with low postoperative morbidity.