Obituary
Editorials
Expert Commentary
General Thoracic Surgery (GTS)
Surgery for Acquired Cardiovascular Disease (ACD)
Surgery for Congenital Heart Disease (CHD)
Evolving Technology (ET)
Cardiopulmonary Support and Physiology (CSP)
Cardiothoracic Transplantation (TX)
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Brief Communications: Clinical
Brief Communications: Research
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Obituary

809 Michael E. DeBakey, 1908 to 2008

Oscar Howard Frazier, MD, Houston, TX

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Editorials

812 Mission Critical: Thoracic Surgery Education Reform

W. Randolph Chitwood, Jr, MD, Thomas L. Spray, MD, Richard H. Feins, MD, and Michael J. Mack, MD, Greenville, NC

814 You Never Know Unless You Try

George L. Hicks, Jr, MD, John W. Brown, MD, John H. Calhoon, MD, and Walter H. Merrill, MD, Chicago, Illinois

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Expert Commentary

816 Fool me once, shame on you; fool me twice, shame on me! A perspective on the emerging world of percutaneous heart valve therapy

Michael Mack, MD, Dallas, Tex

820 Energy loss for evaluating heart valve performance

Cary W. Akins, MD, Brandon Travis, PhD, and Ajit P. Yoganathan, PhD, Boston, Mass, Denmark, and Atlanta, Ga

This review defines what energy loss is, how it is measured, and how it might be applied to clinical situations of heart valve disease to better understand the impact of valvular disease on ventricular function.

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General Thoracic Surgery (GTS)

834 The short esophagus: Intraoperative assessment of esophageal length

Sandro Mattioli, MD, Maria Luisa Lugaresi, MD, PhD, Mario Costantini, MD, Alberto Del Genio, MD, Natale Di Martino, MD, Landino Fei, MD, Uberto Fumagalli, MD, Vincenzo Maffettone, MD, Luigi Monaco, MD, Mario Morino, MD, Fabrizio Rebecchi, MD, Riccardo Rosati, MD, Mauro Rossi, MD, Stefano Santi, MD, Vincenzo Trapani, MD, and Giovanni Zaninotto, MD, Bologna, Padova, Naples, Milan, Turin, and Pisa, Italy

The distance between the EG junction localized by intraoperative endoscopy and the diaphragmatic hiatus was measured in 180 patients undergoing antireflux surgery. After esophageal mediastinal dissection, this distance was shorter than 1.5 cm in 18.8% of patients. Short esophagus is an important issue in patients undergoing GERD surgery.

842 Expert commentary: A multicenter study to define the incidence of short esophagus in surgical patients with gastroesophageal reflux disease

F. Griffith Pearson, MD, Mansfield, Ontario, Canada

843 Autologous fibrin sealant reduces the incidence of prolonged air leak and duration of chest tube drainage after lung volume reduction surgery: A prospective randomized blinded study

C. Moser, MD, I. Opitz, MD, W. Zhai, MD, V. Rousson, MD, E. W. Russi, MD, W. Weder, MD, and D. Lardinois, MD, Zurich, Switzerland

This prospective randomized study demonstrated that thoracoscopic application of autologous sealant along the staple lines significantly reduces the incidence and the duration of prolonged air leak as well as the duration of chest tube drainage after LVRS in patients with end-stage emphysema.

850 Intrathoracic esophageal replacement by in situ tissue-engineered esophagus

Yuen Nakase, MD, PhD, Tatsuo Nakamura, MD, PhD, Shuichi Kin, MD, PhD, Susumu Nakashima, MD, PhD, Tetsuji Yoshikawa, MD, PhD, Yoshiaki Kuriu, MD, PhD, Chohei Sakakura, MD, PhD, Hisakazu Yamagishi, MD, PhD, Junji Hamuro, PhD, Yoshito Ikada, PhD, Eigo Otsuji, MD, PhD, and Akeo Hagiwara, MD, PhD, Nara and Kyoto, Japan

Partial intrathoracic esophageal replacement was successfully performed by using an in situ tissue-engineered esophagus that showed well-differentiated, stratified squamous cells on its luminal surface and contained thick smooth muscle tissue without any complication for 420 days. This procedure may offer a promising surgical approach to esophageal diseases.

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Surgery for Acquired Cardiovascular Disease (ACD)

860 Reoperative aortic root and transverse arch procedures: A comparison with contemporaneous primary operations

Christian D. Etz, MD, Konstadinos A. Plestis, MD, Tobias M. Homann, MD, Carol A. Bodian, DrPH, Gabriele Di Luozzo, MD, David Spielvogel, MD, and Randall B. Griepp, MD, New York, NY

When comparing reoperative (n = 200) and contemporaneous primary (n = 480) root/ascending aorta and arch procedures, operative mortality was higher for reoperative (vs primary) root/ascending aorta procedures (7% vs 3%, P = .07) but comparable for reoperative (vs primary) arch procedures (9% vs 10%, P = .97). The long-term outlook was better after root than after arch operations, with no difference between primary and reoperative procedures.

868 Chordal translocation for ischemic mitral regurgitation may ameliorate tethering of the posterior and anterior mitral leaflets

Shinji Masuyama, MD, Akira Marui, MD, PhD, Takeshi Shimamoto, MD, Michihito Nonaka, MD, Miwako Tsukiji, MD, Nozomi Watanabe, MD, PhD, Tadashi Ikeda, MD, PhD, Kiyoshi Yoshida, MD, PhD, and Masashi Komeda, MD, PhD, Kyoto and Kurashiki, Japan

Secondary chordal cutting ameliorates tethering of the anterior mitral leaflet, but not the posterior mitral leaflet, and affects valvular-ventricular continuity. “Chordal translocation” is a novel subvalvular approach that corrects both anterior and posterior tethering and maintains LV function. We investigated its efficacy in a canine model of acute IMR.

876 Vascular adaptation of the internal thoracic artery graft early and late after bypass surgery

Beat H. Walpoth, MD, Markus Schmid, MD, Anna Schwab, MD, Andreas Bosshard, MD, Friedrich Eckstein, MD, Thierry Carrel, MD, and Otto M. Hess, MD, Geneva and Bern, Switzerland

Myocardial flow mismatch between the supplying artery and the myocardial perfusion region was evaluated after internal thoracic artery grafting. We studied graft flow in 30 patients undergoing coronary artery bypass grafting intraoperatively and 3 and 10 months postoperatively. A significantly reduced internal thoracic artery flow and flow reserve was found intraoperatively, which normalized postoperatively.

884 Pexelizumab in ischemic heart disease: A systematic review and meta-analysis on 15,196 patients

L. Testa, MD, PhD, FEAPCI, W. J. Van Gaal, MD, FRACP, R. Bhindi, MD, PhD, FESC, G. G. L. Biondi-Zoccai, MD, A. Abbate, MD, P. Agostoni, MD, I. Porto, MD, F. Andreotti, MD, FESC, F. Crea, MD, FESC, FACC, and A. P. Banning, MD, FESC, Oxford, United Kingdom, Richmond, Va, Antwerp, Belgium, and Rome and Turin, Italy

Pexelizumab has been postulated to improve outcomes in patients undergoing CABG and urgent reperfusion therapy for STEMI. We aimed at evaluating the risk/benefit profile of pexelizumab (bolus + infusion) versus placebo. Electronic and manual searches of randomized controlled trials have been done. No benefit of adding pexelizumab was found in the overall analysis for MAEs, death, MI, stroke, heart failure, nor in the settings of patients with STEMI. Pexelizumab was associated with a 26% reduction of the risk of death in the setting of CABG. The number needed to treat was 100.

894 The influence of seasonal variation on cardiac surgery: A time-related clinical outcome predictor

Jeffrey H. Shuhaiber, MD, Kimberley Goldsmith, MA, and Samer A. M. Nashef, FRCS, Cambridge, United Kingdom

Cardiac surgery outcomes are influenced by the time of year. Over a 10 year period, we found that coronary artery bypass grafting performed during the summer season had a lower risk-adjusted mortality and shorter hospital stay than the winter season. Potential explanations for this new findings are discussed further.

900 In situ tissue regeneration using a novel tissue-engineered, small-caliber vascular graft without cell seeding

Takenori Yokota, MD, Hajime Ichikawa, MD, PhD, Goro Matsumiya, MD, PhD, Toru Kuratani, MD, PhD, Taichi Sakaguchi, MD, PhD, Shigemitsu Iwai, MD, PhD, Yukitoshi Shirakawa, MD, PhD, Kei Torikai, MD, PhD, Atsuhiro Saito, PhD, Eiichiro Uchimura, PhD, Naomasa Kawaguchi, PhD, Nariaki Matsuura, MD, PhD, and Yoshiki Sawa, MD, PhD, Osaka, Japan

We developed a novel tissue-engineered, biodegradable, small-caliber vascular graft that promotes autologous tissue regeneration without requiring the pretreatment with cell seeding. The tissue-engineered vascular grafts showed morphologic evidence of good in situ tissue regeneration and patency throughout the 12-month postimplantation in a mongrel dog model.

908 Short- and long-term efficacy of aspirin and clopidogrel for thromboprophylaxis for mechanical heart valves: An in vivo study in swine

Stephen H. McKellar, MD, Jess L. Thompson, III, MD, Raul F. Garcia-Rinaldi, MD, Ryan J. MacDonald, BS, Thoralf M. Sundt, III, MD, and Hartzell V. Schaff, MD, Rochester, Minn, and Mayaguez, Puerto Rico

Combination antiplatelet therapy consisting of aspirin and clopidogrel is effective for short- and long-term thromboprophylaxis of bileaflet mechanical valves in swine.

915 The role of temporary biventricular pacing in the cardiac surgical patient with severely reduced left ventricular systolic function

Rudolph F. Evonich, MD, John C. Stephens, MD, William Merhi, DO, Srinivas Dukkipati, MD, Nicholas Tepe, MD, Francis Shannon, MD, Jeffrey Altshuler, MD, Marc Sakwa, MD, Joseph Bassett, MD, Eric Hanson, MD, Judy Boura, MS, William W. O'Neill, MD, and David E. Haines, MD, Royal Oak, Michigan

Some cardiac surgeons advocate the routine use of temporary atrial synchronous biventricular pacing for high-risk postoperative patients. The studies supporting this practice are small and nonrandomized. The current randomized study demonstrates that this practice is not helpful and may be harmful in some patients.

922 Characterization of the inflammatory cells in ascending thoracic aortic aneurysms in patients with Marfan syndrome, familial thoracic aortic aneurysms, and sporadic aneurysms

Rumin He, MD, Dong-Chuan Guo, PhD, Wei Sun, PhD, Christina L. Papke, BS, Senthil Duraisamy, PhD, Anthony L. Estrera, MD, Hazim J. Safi, MD, Chul Ahn, PhD, L. Maximilian Buja, MD, Frank C. Arnett, MD, Jingwu Zhang, MD, Yong-Jian Geng, MD, PhD, and Dianna M. Milewicz, MD, PhD, Houston, Texas

This study sought to investigate the infiltration of T lymphocytes and macrophage in the aortas of patients with MFS, FTAA, and sporadic TAAs. The results indicate that infiltration of inflammatory cells contributes to the pathogenesis of TAAs and that superantigen-driven stimulation of T lymphocytes may contribute to the initial immune response.

930 Interaction between two predictors of functional outcome after revascularization in ischemic cardiomyopathy: Left ventricular volume and amount of viable myocardium

Mohammad Hossein Mandegar, MD, Mohammad Ali Yousefnia, MD, Farideh Roshanali, MD, Hussein Rayatzadeh, MD, and Farshid Alaeddini, MD, PhD, Tehran, Iran

This study investigated the interaction between the left ventricular volume and the amount of viable myocardium to predict the left ventricular ejection fraction increase after revascularization. Patients with 6 viable segments showed a good outcome; the left ventricular end-systolic volume played a major role in the prognosis of those with fewer than 6 viable segments.

937 Is aortic wall degeneration related to bicuspid aortic valve anatomy in patients with valvular disease?

Claudio F. Russo, MD, Aldo Cannata, MD, Marco Lanfranconi, MD, Ettore Vitali, MD, Andrea Garatti, MD, and Edgardo Bonacina, MD, Milan, Italy

Patients with bicuspid aortic valve are at increased risk for aortic complications.

943 Stentless valves versus stented bioprostheses at the aortic position: Midterm results

Sumit Narang, MS, Deepak Kumar Satsangi, MCh, Amit Banerjee, MCh, and Muhammad Abid Geelani, MCh, New Delhi, India

Stentless vales result in greater improvement in left ventricular function compared with stented bioprostheses in patients with left ventricular impairment or a small aortic annulus.

948 The transapical approach for aortic valve implantation

Andreas Zierer, MD, Gerhard Wimmer-Greinecker, MD, Sven Martens, MD, Anton Moritz, MD, and Mirko Doss, MD, Frankfurt/Main, Germany

We report on the initial 26 patients in whom the transapical approach for antegrade placement of a catheter-deliverable aortic valve was successfully performed at our institution. Initial results are encouraging, including the absence of permanent neurologic deficits. The transapical approach provides an attractive alternative to percutaneous aortic valve implantation.

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Surgery for Congenital Heart Disease (CHD)

954 Mitral valve replacement in infants and children 5 years of age or younger: Evolution in practice and outcome over three decades with a focus on supra-annular prosthesis implantation

Elif Seda Selamet Tierney, MD, Frank A. Pigula, MD, Charles I. Berul, MD, James E. Lock, MD, Pedro J. del Nido, MD, and Doff B. McElhinney, MD, Boston, Mass

Among 118 children who underwent mitral valve replacement (MVR) at 5 years of age or younger from 1976–2006, supra-annular MVR was associated with worse survival than annular MVR in our recent experience. Patients with supra-annular MVR were less likely to have operative complete heart block but remained at risk when the prosthesis was subsequently replaced.

962 Regional differences in tissue oxygenation during cardiopulmonary bypass for correction of congenital heart disease in neonates and small infants: Relevance of near-infrared spectroscopy

Mathias Redlin, MD, Andreas Koster, MD, Michael Huebler, MD, Wolfgang Boettcher, ECCP, Nicole Nagdyman, MD, Roland Hetzer, MD, Hermann Kuppe, MD, and Wolfgang M. Kuebler, MD, Berlin, Germany

In neonates and small infants with congenital heart disease, regional differences in venous oxygen saturation and lactate level may lead to systematic overestimation of upper-body oxygenation. Continuous noninvasive monitoring with near-infrared spectroscopy may assist in early and sensitive detection of regional malperfusion in such critical organs as the brain.

968 Design and rationale of a randomized trial comparing the Blalock–Taussig and right ventricle–pulmonary artery shunts in the Norwood procedure

Richard G. Ohye, MD, J. William Gaynor, MD, Nancy S. Ghanayem, MD, Caren S. Goldberg, MD, MS, Peter C. Laussen, MBBS, Peter C. Frommelt, MD, Jane W. Newburger, MD, MPH, Gail D. Pearson, MD, ScD, Sarah Tabbutt, MD, PhD, Gil Wernovsky, MD, Lisa M. Wruck, PhD, Andrew M. Atz, MD, Steve D. Colan, MD, James Jaggers, MD, Brian W. McCrindle, MD, MPH, Ashwin Prakash, MD, Michael D. Puchalski, MD, Lynn A. Sleeper, ScD, Mario P. Stylianou, PhD, and Lynn Mahony, MD, for the Pediatric Heart Network Investigators (see Appendix), Ann Arbor, Mich, Philadelphia, Pa, Milwaukee, Wisconsin, Boston, Mass, Bethesda, Md, Watertown, Mass, Charleston, SC, Durham, NC, Ontario, Canada, New York, NY, Salt Lake City, Utah, and Dallas, Tex

The Pediatric Heart Network designed a randomized clinical trial to compare the modified Blalock–Taussig and right ventricle–pulmonary artery shunts in the Norwood procedure. This study will make an important contribution to the management of hypoplastic left heart syndrome and establishes a model for future surgical trials in congenital heart surgery.

976 Two–year survival, mental, and motor outcomes after cardiac extracorporeal life support at less than five years of age

Laurance Lequier, MD, Ari R. Joffe, MD, Charlene M. T. Robertson, MD, Irina A. Dinu, PhD, Yuttapong Wongswadiwat, MD, Natalie R. Anton, MD, David B. Ross, MD, and Ivan M. Rebeyka, MD, for the Western Canadian Complex Pediatric Therapies Program Follow-up Group, Alberta, Canada, and Khon Kaen, Thailand

Children (n = 39) having cardiac ECLS were followed up for outcome. Two-year survival was 16 (41%). In survivors, mental score was 73 ± 16. Single ventricle anatomy and admission lactate were associated with mortality. CPR was not associated with mortality or mental delay. Three variables explained 77% of the variance in mental outcome.

984 Survival after extracorporeal cardiopulmonary resuscitation in infants and children with heart disease

Titus Chan, MD, Ravi R. Thiagarajan, MBBS, MPH, Deborah Frank, MD, PhD, and Susan L. Bratton, MD, MPH, Boston, Mass

We investigated survival and factors associated with mortality for children with heart disease who were started on extracorporeal membrane oxygenation (ECMO) as an adjunct to conventional cardiopulmonary resuscitation. Underlying cardiac physiology, complexity of the surgical procedure, pre-ECMO resuscitation status, and ECMO complications influenced survival to hospital discharge in this population.

993 Measurement of technical performance in surgery for congenital heart disease: The stage I Norwood procedure

Emile A. Bacha, MD, Luis A. Larrazabal, MD, Frank A. Pigula, MD, Kimberlee Gauvreau, ScD, Kathy J. Jenkins, MD, Steve D. Colan, MD, Francis Fynn-Thompson, MD, John E. Mayer, Jr, MD, and Pedro J. del Nido, MD, Boston, Mass

A technical score was created for the stage I Norwood procedure to evaluate pure technical performance. The score was validated and correlated with early outcomes.

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Evolving Technology (ET)

998 Intraoperative verification of conduction block in atrial fibrillation surgery

Yosuke Ishii, MD, Takashi Nitta, MD, Masaru Kambe, MD, Jiro Kurita, MD, Masami Ochi, MD, Yasushi Miyauchi, MD, and Kazuo Shimizu, MD, Tokyo, Japan

Incomplete surgical ablation during atrial fibrillation surgery can cause atrial tachycardia postoperatively. The majority of postoperative atrial tachycardia was associated with an incomplete coronary sinus ablation. Intraoperative verification of conduction block may prevent the occurrence of postoperative atrial tachycardia.

1005 Persistent atrial fibrillation in a goat model of chronic left atrial overload

Jan Remes, MD, Thomas J. van Brakel, MD, PhD, Gil Bolotin, MD, PhD, Christian Garber, MD, Monique M. de Jong, BSc, Frederik H. van der Veen, PhD, and Jos G. Maessen, MD, PhD, Maastricht, The Netherlands, and Brussel, Belgium

An animal model of left atrial overload induced by an aortic left atrial shunt is described. During a 4-week overload period, progress in atrial dilatation and its electrophysiologic effect were evaluated in nonanesthetized goats. Persistent atrial fibrillation (>1 week) could be induced.

1012 Evaluation of a new disease-specific endovascular device for type B aortic dissection

Germano Melissano, MD, Luca Bertoglio, MD, Andrea Kahlberg, MD, Domenico Baccellieri, MD, Massimiliano M. Marrocco-Trischitta, MD, Fabio Calliari, MD, and Roberto Chiesa, MD, Milan, Italy

This study evaluates the feasibility, safety, and early technical and clinical success rate of the Zenith Dissection Endovascular System (William Cook Europe, Bjaerverskov, Denmark), a device recently available in Europe, for the treatment of type B aortic dissection. Our preliminary results show that the device can be safely used without affecting the patency of the branches covered by the bare stent.

1019 A novel device for left atrial appendage exclusion: The third-generation atrial exclusion device

Hideyuki Fumoto, MD, A. Marc Gillinov, MD, Yoshio Ootaki, MD, PhD, Masatoshi Akiyama, MD, PhD, Diyar Saeed, MD, Tetsuya Horai, MD, Chiyo Ootaki, MD, D. Geoffrey Vince, PhD, Zoran B. Popović, MD, Raymond Dessoffy, AA, Alex Massiello, MEBME, Jacquelyn Catanese, MA, and Kiyotaka Fukamachi, MD, PhD, Cleveland, Ohio

The third-generation atrial exclusion device achieved easy, reliable, and safe exclusion of the left atrial appendage with favorable histologic results in dogs. Clinical application could provide a new therapeutic option for reducing the risk of stroke in patients with atrial fibrillation.

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Cardiopulmonary Support and Physiology (CSP)

1028 Multimodal evaluation of in vivo magnetic resonance imaging of myocardial restoration by mouse embryonic stem cells

Stephen L. Hendry, II, MD, Koen E. A. van der Bogt, MS, Ahmad Y. Sheikh, MD, Takayasu Arai, MD, Scott J. Dylla, PhD, Micha Drukker, PhD, Michael V. McConnell, MD, Ingo Kutschka, MD, Grant Hoyt, BS, Feng Cao, MD, PhD, Irving L. Weissman, MD, Andrew J. Connolly, MD, PhD, Marc P. Pelletier, MD, Joseph C. Wu, MD, PhD, Robert C. Robbins, MD, and Phillip C. Yang, MD, Stanford, Calif, and Leiden, The Netherlands

Multimodal evaluation of the restorative effects of transplanting embryonic stem cells into the infarcted heart can provide insight into the mechanism of action. Magnetic resonance imaging of myocardial restoration is correlated with improved functional capacity, robust cell survival, increased expression of protective genes, and cardiomyogenic differentiation.

1038 Effects of carbamazepine on spinal cord ischemia

Mustafa Sırlak, MD, Sadik Eryılmaz, MD, Mustafa Bahadır Inan, MD, Yusuf Sinan Sırın, DVM, Omer Besaltı, DVM, PhD, Levent Yazıcıoglu, MD, Evren Ozcınar, MD, Esra Erdemlı, MD, Refik Tasoz, MD, Atilla Halil Elhan, PhD, Bulent Kaya, MD, and Umit Ozyurda, MD, Ankara and Samsun, Turkey

This is a randomized controlled study based on a rabbit model showing the protective effects of carbamazepine on a spinal cord ischemic reperfusion injury.

1044 CCR3- and CXCR4-mediated interactions regulate migration of CD34+ human bone marrow progenitors to ischemic myocardium and subsequent tissue repair

N. Bonaros, MD, H. Sondermejer, MD, M. Schuster, PhD, R. Rauf, MD, S. F. Wang, MD, T. Seki, PhD, D. Skerrett, MD, S. Itescu, MD, and A. A. Kocher, MD, Innsburck, Austria, and New York, NY

This study elucidates the role of CCR3 and CXCR4 chemokine receptors in migration of hematopoietic progenitors after myocardial infarction. CCR3-dependent chemokine interactions regulate endogenous migration of CD34+ progenitors from bone marrow to ischemic myocardium. Manipulating CXCR4-dependent interactions could enhance the efficacy of cell therapy after myocardial infarction.

1054 Platelet activity and aspirin efficacy after off-pump compared with on-pump coronary artery bypass surgery: Results from the prospective randomized trial PRAGUE 11–Coronary Artery Bypass and REactivity of Thrombocytes (CABARET)

Frantisek Bednar, MD, PhD, Pavel Osmancik, MD, PhD, Tomas Vanek, MD, PhD, Heidi Mocikova, MD, PhD, Martin Jares, MD, Zbynek Straka, MD, PhD, and Petr Widimsky, MD, PhD, FESC, Prague, Czech Republic

We performed a comparison of early and late platelet activity (P-selectin expression) and aspirin efficacy (arachidonic acid–induced platelet aggregation) between groups undergoing off-pump and on-pump coronary artery bypass grafting. In the off-pump group there was significantly higher platelet activity early after surgical intervention, and in both groups aspirin insufficiency in the inhibition of platelet aggregation was recorded early after the operation.

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Cardiothoracic Transplantation (TX)

1061 Should lung transplantation be performed using donation after cardiac death? The United States experience

David P. Mason, MD, Lucy Thuita, MS, Joan M. Alster, MS, Sudish C. Murthy, MD, PhD, Marie M. Budev, DO, Atul C. Mehta, MD, Gösta B. Pettersson, MD, PhD, and Eugene H. Blackstone, MD, Cleveland, Ohio

Lung transplantation using donation after cardiac death (DCD) can substantially increase the number of allograft recipients, but widespread acceptance has been slow, and clinical outcomes are uncertain. Survival after DCD as practiced in the United States is excellent and supports expanded use.

1067 Carbon monoxide–saturated preservation solution protects lung grafts from ischemia–reperfusion injury

Junichi Kohmoto, MD, Atsunori Nakao, MD, Ryujiro Sugimoto, MD, Yinna Wang, MD, JiangHua Zhan, MD, Hideo Ueda, PhD, and Kenneth R. McCurry, MD, Pittsburgh, Pa, and Osaka, Japan

Carbon monoxide (CO) at low concentrations is known to have potent cytoprotective effects. Our study, using a rat lung transplant model, demonstrated that 5% CO as an additive to the cold flush/preservation solution can ameliorate cold ischemia–reperfusion injury after prolonged cold preservation.

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Brief Communications: Technical

1076 Pitfalls in catheter-based interventions to treat paravalvular leaks

Andreas Bairaktaris, MD, Nikolaus A. Haas, MD, Dirk Seifert, MD, Rainer Schaeffler, MD, Heinrich Koertke, MD, Soren Schenk, MD, and Reiner Koerfer, MD, Bad Oeynhausen, Germany

1077 Resection of a giant thoracic solitary fibrous tumor through two separate thoracotomies

Chao-Kai Hu, MD, Yih-Leong Chang, MD, Wei-Cheng Lin, MD, and Yung-Chie Lee, MD, PhD, Taipei, Taiwan

1080 Partial resection of persistent left superior vena cava for a T4 lung cancer

Erdal Okur, MD, Cagatay Tezel, MD, Volkan Baysungur, MD, and Semih Halezeroğlu, MD, Istanbul, Turkey

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Brief Communications: Clinical

1082 Hypoxemia after an axial flow pump Jarvik-2000 implantation: Catheter induced

Joonhwa Hong, MD, Soon J. Park, MD, Sunil V. Mankad, MD, Frank Cetta, Jr, MD, Norman E. Torres, MD, and Morgan L. Brown, MD, Rochester, Minnesota

1084 Aortic root aneurysm in Takayasu arteritis syndrome: Exploration in active phase and repair in inactive phase

Min-Ho Song, MD, PhD, Tomohiro Nakayama, MD, Keisuke Hattori, MD, Yoshiyuki Tokuda, MD, Yukio Mabuchi, MD, and Yuichi Ueda, MD, PhD, Gifu and Aichi, Japan

1085 Partial left pulmonary artery sling associated with multiple ventricular septal defects: A rare congenital anomaly

C. Tissot, MD, J. R. Darst, MD, A. K. Kaza, MD, A. K. Younoszai, MD, and E. da Cruz, MD, Denver, Colo

1087 Cardiac tamponade secondary to traumatic intrapericardial diaphragmatic hernia

Affes Nejmeddine, MD, Abdenader Mohamed, MD, Khemakem Khalil, MD, Ben Salah Khalil, MD, and Beyrouti Mohamed Issam, MD, Sfax, Tunisia

1089 Identification by transesophageal echocardiography of intramural hematoma and the site of aortic rupture

Kazumasa Orihashi, MD, Taijiro Sueda, MD, Kenji Okada, MD, and Katsuhiko Imai, MD, Hiroshima, Japan

1091 Aortoesophageal fistula associated with a Kommerell diverticulum and right-sided aortic arch

Karl G. Reyes, MD, Inderjit S. Gill, MD, Thomas Temes, MD, and Noreen C. Griffin, CNP, Cleveland, Ohio

1093 Recurrent sarcoma originating from the pulmonary artery 6 years after extensive thoracic resection

Christine Fegbeutel, MD, Martin Strüber, MD, Jan U. Becker, MD, Florian Länger, MD, Nicolas Dickgreber, MD, Axel Haverich, MD, and Stefan Fischer, MD, MSc, Hannover, Germany

1095 Mitral annuloplasty in an infant with Barth syndrome and severe mitral insufficiency: First case report and determination of annular diameter

Shu-Chien Huang, MD, En-Ting Wu, MD, Shuenn–Nan Chiu, MD, Wuh-Liang Hwu, MD, Mei-Hwan Wu, MD, PhD, and Shoei-Shen Wang, MD, PhD, Taipei, Taiwan

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Brief Communications: Research

1098 Pediatric cardiac transplantation: Three-dimensional printing of anatomic models for surgical planning of heart transplantation in patients with univentricular heart

Ralf Sodian, MD, Stefan Weber, PhD, Mathias Markert, MSc, Markus Loeff, MD, Tim Lueth, PhD, Florian C. Weis, MD, Sabine Daebritz, MD, Edward Malec, MD, Christoph Schmitz, MD, and Bruno Reichart, MD, Munich and Garching, Germany

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Letters to the editor

1100 Statins with equivalent lipid-lowering capacity exhibit differential effects on atrial fibrillation after cardiac surgery

Antonios Kourliouros, MRCS, Neil Roberts, MRCS, and Marjan Jahangiri, FRCS, London, UK

1101 Reply to the Editor

Craig Ian Coleman, PharmD, Storrs, Conn

1101 Box lesion or not—Still unsettled question

Uma N. Srivatsa, MD, Sacramento, CA

1101 Aortic valve replacement dilemma: mechanical or biological prosthesis?

Aldo Cannata, MD, Claudio Francesco Russo, MD, and Corrado Taglieri, MD, Milan, Italy

1102 Reply to the Editor

Morgan Brown, MD, and Hartzell Schaff, MD, Rochester, MN

1102 Importance of stabilization of the mitral annulus in mitral valve repair

István Szentkirályi, MD, Árpád Péterffy, MD, PhD, and Zoltán Galajda, MD, PhD, Debrecen, Hungary

1103 Reply to the Editor

W. Flameng, MD, PhD, Leuven, Belgium

1103 Questions on the angular (Gothic) arch configuration and its applicability after type I aortic dissection repair

Frank A. Baciewicz, Jr, MD, Detroit, MI

1104 Aprotinin and renal dysfunction: The role of exposure to angiotensin-converting enzyme inhibitors

John G. T. Augoustides, MD, FASE, Philadelphia, PA

1104 Reply to the Editor

Domenico Pagano, MD, FRCS, FESC, West Midlands, United Kingdom

1104 Prosthetic valve thrombosis: A regimen of treatment with low-dose and longer-course using recombinant tissue-type plasminogen activator is a promising protocol

Fidel Manuel Cáceres-Lóriga, MD, PhD, Horacio Pérez-López, MD, PhD, and Karel Morlans-Hernández, MD, Havana, Cuba

1105 Optimizing selective cerebral perfusion in adult aortic arch repair: Clinical relevance of the laboratory model

John G. T. Augoustides, MD, FASE, Philadelphia, PA

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