In Langendorff perfusions, dichloroacetate increased rat right ventricular inotropy in hypertrophied right ventricles ( P < .01) but not in normal right ventricles, suggesting that mitochondrial hyperpolarization in right ventricular hypertrophy might be associated with its suboptimal performance.

Conclusions: The dynamic changes in mitochondrial membrane potential during right ventricular Stem Cells inhibitor hypertrophy are chamber-specific, associated with activation of NFAT, and can be pharmacologically reversed leading to improved contractility. This

mitochondrial remodeling might provide a framework for development of novel right ventricle-specific therapies.”
“Objective: Postpneumonectomy empyema remains a clinical challenge. We proposed an accelerated therapy without an open chest window 5 years ago. This concept was evaluated on a larger scale in 2 centers in 2 different countries.

Methods: Between July 1995 and October 2005, 75 consecutive patients with postpneumonectomy empyema were treated in Szczecin, Poland ( n = 35), and Zurich, Switzerland ( n 5 40). The therapy consisted of repeated open surgical debridement of the pleural cavity after achievement of general anesthesia, a negative pressure wound therapy of the temporarily

closed chest cavity filled Idasanutlin concentration with povidone-iodine soaked towels, and continuous suction and systemic antimicrobial therapy. If present, bronchopleural fistulae were closed and reinforced either with a muscle flap or the omentum. Finally, the pleural space was filled with an antibiotic solution and definitively closed.

Results: Of 75 patients ( 63 men; median age, 59 years;

selleck inhibitor age range, 19 – 82 years), postpneumonectomy empyema was present on the right in 46 patients ( 32 with bronchopleural fistula) and in 29 patients ( 12 with bronchopleural fistula) on the left. Median time between pneumonectomy and postpneumonectomy empyema was 131 days ( range, 7 – 7200 days). Bronchopleural fistulae have been closed and additionally reinforced by means of different methods ( omentum, 18; muscle, 11; pericardial fat, 5; azygos vein, 1). The chest was definitively closed within 8 days in 94.6% of patients. The median hospitalization time was 18 days ( range, 9 – 134 days). Postpneumonectomy empyema was successfully treated in 97.3% of patients, including 10 ( 13%) patients who needed a second treatment cycle. Three ( 4%) patients died within 90 days. The median follow-up time was 29.5 moths ( range, 3 – 107 months).

Conclusions: Treatment of postpneumonectomy empyema with the accelerated treatment is effective and safe. Our results are superior compared with those in reported series using a ( temporary) chest fenestration. Patients appreciate the physical integrity of the chest.