The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 1986
Complications of tracheal reconstruction. Incidence, treatment, and prevention.
Between 1962 and 1982, 416 primary tracheal reconstructions and 21 staged reconstructions were performed. Since then 80 additional tracheal reconstructions have been accomplished (to April of 1985). ⋯ The first and second halves of the series have therefore been compared. Measures to prevent complications are discussed.
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J. Thorac. Cardiovasc. Surg. · Mar 1986
Surgical results for mitral regurgitation from coronary artery disease.
Results of coronary artery bypass grafting with and without mitral valve replacement were analyzed retrospectively in 101 patients with preoperative ischemic mitral regurgitation to determine the effects of severity and surgical treatment of mitral regurgitation on survival. Between 1980 and 1984, a total of 1,475 patients (mean age 59, 77% male) underwent coronary bypass. These patients were divided into three groups: (1) patients without ischemic mitral regurgitation who underwent isolated coronary bypass (1,374; 93%), (2) patients with ischemic mitral regurgitation who underwent isolated coronary bypass without valve replacement (85; 6%), and (3) patients with ischemic mitral regurgitation who underwent combined mitral valve replacement and coronary bypass (16; 1%). ⋯ The actuarial survival rate at 5 years for the coronary bypass patients without ischemic mitral regurgitation was 85% compared to 91% (p less than 0.05) for the coronary bypass patients without ischemic mitral regurgitation. These results indicate that patients with ischemic mitral regurgitation have a higher prevalence of cardiac risk factors and are at an increased risk of operative mortality. Although the severity of the ischemic mitral regurgitation was strongly predictive of early survival, it proved to have an unexpectedly modest effect on long-term survival after surgical treatment.
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J. Thorac. Cardiovasc. Surg. · Feb 1986
Comparative StudyInhibition of pulmonary surfactant by plasma from normal adults and from patients having cardiopulmonary bypass.
Plasma from normal adults and from children and adults having cardiopulmonary bypass inhibited the ability of pulmonary surfactant to reach low surface tension in proportion to the amount of protein added. No increase in the extent of inhibition of surfactant action per milligram of protein was seen in plasma taken before or after bypass in adults or children.
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J. Thorac. Cardiovasc. Surg. · Feb 1986
Case ReportsSubarachnoid-pleural fistula. Case report and review of the literature.
A case is described of a subarachnoid-pleural fistula developing after resection of an intrathoracic benign nerve sheath tumor near the eleventh thoracic vertebra. The fistula was demonstrated by myelography and was corrected surgically. Of 12 previously reported cases, 11 occurred after trauma and one after an operation.
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J. Thorac. Cardiovasc. Surg. · Nov 1985
Twelve-year experience with internal mammary artery for coronary artery bypass.
From Feb. 1, 1972, to Jan. 30, 1984, 1,000 patients had isolated coronary bypass with at least one internal mammary artery, and 103 of them had bilateral internal mammary artery grafts. There were 1,395 associated vein grafts and 1,158 internal mammary artery anastomoses, for a total of 2,556 grafts (2.5 per patient). Patients were followed up for 1 to 12 years (mean 6.3 years) and 77 patients were lost to follow-up at a mean of 4.0 years. ⋯ Of the 58 sequential internal mammary artery grafts, 18 were studied by catheterization (mean interval 2.0 years); 35 of 36 anastomoses were patent and one end-to-side anastomosis was closed. Morbidity and mortality for patients having internal mammary artery grafting are comparable to those of patients having saphenous vein bypass only. The demonstrated superior patency for internal mammary artery grafts supports the routine use of bilateral internal mammary artery grafting.