The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2001
Comparative StudyLong-term results of the lateral tunnel Fontan operation.
Completion of a total cavopulmonary anastomosis with an intra-atrial lateral tunnel is known to yield good early and midterm results. In this study, we sought to determine the long-term outcome (10 years) after a lateral tunnel Fontan procedure. ⋯ The lateral tunnel Fontan procedure results in excellent long-term outcome even when used in patients with diverse anatomic diagnoses. The incidence of atrial tachyarrhythmia is low and mainly depends on the underlying cardiac morphology and preoperative arrhythmia. The good long-term outcome after an intracardiac lateral tunnel Fontan procedure should serve as a basis for comparison with other surgical alternatives.
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J. Thorac. Cardiovasc. Surg. · Jan 2001
Comparative StudyPartial cricoidectomy with primary thyrotracheal anastomosis for postintubation subglottic stenosis.
We describe a Pearson-type technique and evaluate its results for postintubation subglottic stenosis. ⋯ Partial cricoidectomy with primary thyrotracheal anastomosis can be applied in patients with postintubation stenosis extending up to 1 cm below the cords and measuring up to 6 cm in length with excellent-to-good definitive results. The association with a tracheoesophageal fistula does not contraindicate surgical repair.
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J. Thorac. Cardiovasc. Surg. · Jan 2001
Comparative StudyIschemic preconditioning with opening of mitochondrial adenosine triphosphate-sensitive potassium channels or Na/H exchange inhibition: which is the best protective strategy for heart transplants?
This study was designed to compare ischemic preconditioning with opening of mitochondrial adenosine triphosphate-sensitive potassium channels and Na(+)/H(+) exchange inhibition in an isolated heart model of cold storage, simulating the situation of cardiac allografts. ⋯ These data suggest that cardioprotection conferred by the Na(+)/H(+) exchange inhibitor cariporide is additive to that of ischemic preconditioning and might effectively contribute to improve donor heart preservation during cardiac transplantation.
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J. Thorac. Cardiovasc. Surg. · Dec 2000
The role of silicone stents in the treatment of cicatricial tracheal stenoses.
Tracheal stenting for cicatricial stenoses is reserved for patients whose lesions are deemed inoperable for local or general reasons. The aim of our study was to verify the long-term results of silicone tracheal stents in such a clinical setting. ⋯ Long-term treatment with a silicone stent was safe and well tolerated in cicatricial tracheal stenoses. This procedure can be considered as a bridge to curative surgery or as a definitive treatment. The latter, generally performed for palliation, may provide satisfactory therapeutic results in selected patients, even in the presence of severe circumferential stenoses.
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J. Thorac. Cardiovasc. Surg. · Dec 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative efficacy of teicoplanin and cefazolin for cardiac operation prophylaxis in 3027 patients. The ESPRIT Group.
Cephalosporins, especially cefazolin, are widely used in the prevention of postoperative wound infections after cardiac operations. As more and more Staphylococcus aureus and Staphylococcus epidermidis strains are becoming resistant to cephalosporins and other antibiotics, alternative agents, such as glycopeptides, are often used as prophylaxis. We performed a multicenter double-blind randomized controlled trial comparing teicoplanin, a glycopeptide antibiotic, with cefazolin. ⋯ Cefazolin was more effective prophylaxis than teicoplanin against postoperative wound infections after elective cardiac operations. Infection rates were low with either treatment.