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Showing papers in "The Journal of Thoracic and Cardiovascular Surgery in 1993"


Journal ArticleDOI
TL;DR: It is concluded that deep hypothermia withcirculatory arrest is a safe technique for the repair of complex aortic problems provided both the circulatory arrest and the cardiopulmonary bypass times are not excessive.

590 citations


Journal ArticleDOI
TL;DR: This study describes the experience with 10 patients with annuloaortic ectasia who underwent the remodeling procedure at the National Heart Hospital and the Royal Brompton Hospital from 1982 to 1990.

578 citations


Journal ArticleDOI
TL;DR: Fluorescence imaging may become an important adjunct to conventional bronchoscopic examination to improve the ability to diagnose and stage lung cancer more accurately.

376 citations


Journal ArticleDOI
TL;DR: This transcervical-thoracic approach affords a safe exposure and radical resection of non-small-cell lung cancer involving the thoracic inlet and results in encouraging long-term survival.

322 citations


Journal ArticleDOI
TL;DR: The diagnostic, surgical, and postoperative management evolution provided by the coordinated team involved at this institution has established that pulmonary thromboendarterectomy can be performed with an acceptable risk and good hemodynamic and symptomatic results.

315 citations


Journal ArticleDOI
TL;DR: Multivariable analysis showed small diameter of the tricuspid valve, severe right ventricular coronary dependency, birth weight, and the date and type of initial procedure to be risk factors for time-related death.

308 citations


Journal ArticleDOI
TL;DR: Endoscopic surveillance of patients with benign Barrett's esophagus permits detection of carcinoma at an early stage and improves long-term survival after resection for severe dysplasia and invasive carcinoma.

304 citations


Journal ArticleDOI
TL;DR: The presence of complement activation is confirmed and the production of IL-6 after the generation of C5b-9 in patients undergoing cardiopulmonary bypass is demonstrated, which may contribute to adverse systemic reactions associated with cardiopULmonary bypass.

298 citations


Journal ArticleDOI
TL;DR: This study demonstrates the release of interleukin-8 into the circulation after pediatric hypothermic cardiopulmonary bypass and supports the suggestion that this cytokine plays a role in the pathophysiology of capillary leak through neutrophil degranulation.

287 citations


Journal ArticleDOI
TL;DR: Transhiatal esophagectomy is feasible in most patients requiring esophageal resection for either benign or malignant disease and is a safe, well-tolerated operation if performed with care and for the proper indications.

260 citations


Journal ArticleDOI
TL;DR: By multivariable analysis younger recipient age was the only risk factor identified for leaflet failure, and patients followed up for 4 or more years were in New York Heart Association class I or II.

Journal ArticleDOI
TL;DR: Multivariate analysis of factors influencing hospital mortality showed that age, cardiac suture technique, associated surgical procedures, biventricular heart failure, atrial fibrillation, cardiothoracic ratio greater than 60%, and ejection fraction less than 15% were predictors of unfavorable outcome.

Journal ArticleDOI
TL;DR: A retrospective analysis was done of 120 consecutive patients with life-threatening hemoptysis cared for between 1983 and 1990, finding that percutaneous embolization may be effective in nonsurgical candidates.

Journal ArticleDOI
TL;DR: Aprotinin in high doses completely inhibited kallikrein-CĪ-inhibitor complex activation of neutrophils and partially inhibited complement-induced activation, thus attenuating the "whole body inflammatory response" associated with cardiopulmonary bypass.

Journal ArticleDOI
TL;DR: The prevalence of early aortic valve allograft degeneration has prompted the consideration of nonviable allogsrafts or xenografts, pulmonary autografteds, or minimal immunosuppression as alternatives when left ventricular outflow tract reconstruction is necessary in children less than 3 years of age.

Journal ArticleDOI
TL;DR: The gastroepiploic artery is a suitable conduit for coronary artery bypass grafting in terms of low surgical risk, high patency rate, and excellent patient outcome.

Journal ArticleDOI
TL;DR: It is demonstrated that, in children, cardiopulmonary bypass induces complement activation principally via the alternative pathway and the role of multiple system organ failure itself on the C3 conversion and on the synthesis of the markers of the inflammatory response in children after heart operations is pointed out.

Journal ArticleDOI
TL;DR: This combined modality therapy has been well tolerated and has been associated with high response and resectability rates in both stage IIIA and stage IIIB non-small-cell lung cancer, providing a firm basis for subsequent phase III clinical trials.

Journal ArticleDOI
TL;DR: Video-assisted thoracoscopic interruption of the patent ductus arteriosus is feasible in low-weight infants, whereas transcatheter endovascular closure of the ductus usually is not possible, and is applied to premature infants with new instruments designed for the size of these patients.

Journal ArticleDOI
TL;DR: The belief that transhiatal esophagogastrectomy results in the same survival as a more extensive en bloc resection was tested in 69 patients with carcinoma in the distal esophagus and gastric cardia.

Journal ArticleDOI
TL;DR: In conclusion, interrupted aortic arch, severe truncal valve insufficiency, coronary anomalies, and repair later than 100 days of age were risk factors for death after repair of truncus arteriosus, but in the absence of these associations,truncusarteriosus can be repaired with excellent surgical outcome in the neonatal and early infancy period.

Journal ArticleDOI
TL;DR: Neutrophil elastase release during cardiopulmonary bypass is demonstrated but fails to show a definite role for neutrophil activation or tumor necrosis factor-alpha in the etiology of pulmonary dysfunction after cardiopULmonary bypass.

Journal ArticleDOI
TL;DR: A significant decrease in hospital stay was noted with thoracoscopic biopsy when compared with lung biopsy via the standard open approaches and Thoracoscopy provided excellent visualization and allowed for wedge resection that provided adequate tissue for diagnosis in patients with diffuse pulmonary interstitial disease.

Journal ArticleDOI
TL;DR: Data demonstrate that the insufflation of talc into the pleural cavity under thoracoscopic guidance is a safe and efficacious procedure in the control of malignant pleural effusions.

Journal ArticleDOI
TL;DR: It is shown that even patients with an apparently good clinical condition are at risk for arrhythmias, abnormal liver enzyme and function tests, and coagulation factor abnormalities, and serial statement of affairs is recommended.

Journal ArticleDOI
TL;DR: In this paper, 16 patients with invasive thymoma (stage III and stage IVA) were treated with chemotherapy and then operation, and the median survival was 66 months with a 3-year survival of 70%.

Journal ArticleDOI
TL;DR: Tumor size, location, and the presence of symptoms were predictive of malignancy in the adult population but not in the pediatric population, and no difference existed in mortality and morbidity between the two groups.

Journal ArticleDOI
TL;DR: It is concluded that patients with an intrathoracic upside-down stomach who have obstructive symptoms at initial presentation should undergo repair and that elective operation is safe and effective.

Journal ArticleDOI
TL;DR: Investigation of blood activation by interrupting the blood suction from the pericardial cavity during cardiopulmonary bypass in clinical coronary artery bypass operations found thrombin–antithrombin III complex activated by tissue factor and tissue-type plasminogen activator in pericARDial cavity.

Journal ArticleDOI
TL;DR: It is concluded that when relatively rapid core cooling is used to achieve hypothermia before circulatory arrest in young infants, a more alkaline pH strategy such as alpha-stat may result in less effective cerebral protection.