The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 1999
T grafts with the right internal thoracic artery to left internal thoracic artery versus the left internal thoracic artery and radial artery: flow dynamics in the internal thoracic artery main stem.
Complete arterial coronary artery bypass grafting with 2 grafts can be achieved even in triple vessel disease by use of a T configuration. There is still uncertainty whether the coronary flow reserve in the main stem of the left internal thoracic artery is sufficient to supply more than 1 anastomosed coronary vessel. ⋯ Both variants of T grafts allow for complete arterial revascularization with good perioperative results. The flow reserve of the proximal internal thoracic artery is adequate for multiple coronary anastomoses irrespective of the choice of the second arterial graft.
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J. Thorac. Cardiovasc. Surg. · Nov 1999
Cold retrograde cerebral perfusion improves cerebral protection during moderate hypothermic circulatory arrest: A long-term study in a porcine model.
Deep hypothermic circulatory arrest is an effective method of cerebral protection, but it is associated with long cardiopulmonary bypass times and coagulation disturbances. Previous studies have shown that retrograde cerebral perfusion can improve neurologic outcomes after prolonged hypothermic circulatory arrest. We tested the hypothesis that deep hypothermic retrograde cerebral perfusion could improve cerebral outcome during moderate hypothermic circulatory arrest. ⋯ Cold hypothermic retrograde cerebral perfusion during moderate hypothermic circulatory arrest seems to improve neurologic outcome compared with moderate hypothermic circulatory arrest with the head packed in ice.
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J. Thorac. Cardiovasc. Surg. · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialDecreased cerebral emboli during distal aortic arch cannulation: a randomized clinical trial.
Cerebral emboli occur during cardiopulmonary bypass and are a principal cause of postoperative neurologic dysfunction. We hypothesized that arterial cannulation of the distal aortic arch, with placement of the cannula tip beyond the left subclavian artery, will result in fewer cerebral microemboli than conventional cannulation of the ascending aorta. ⋯ Cannulation of the distal aortic arch results in less cerebral microembolism than conventional cannulation of the ascending aorta. Provided it is performed safely, distal arch cannulation may be an important surgical option for patients with severe atherosclerosis of the ascending aorta.