Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2013
ReviewIs there a role for gabapentin in preventing or treating pain following thoracic surgery?
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether gabapentin, a commonly prescribed neuropathic analgesic and anticonvulsant, is safe and beneficial in patients with post-thoracotomy pain following thoracic surgery. Seventeen papers were identified using the search described below, and five papers presented the best evidence to reach conclusions regarding the issues of interest for this review. ⋯ One prospective study of out-patients with chronic pain (>4 weeks since thoracotomy performed) suggested that gabapentin is effective, safe and well tolerated when used for persistent postoperative and post-traumatic pain in thoracic surgery patients. We conclude that there is no evidence to support the role of a single preoperative oral dose of gabapentin in reducing pain scores or opioid consumption following thoracic surgery. Multiple dosing regimens may be beneficial in reducing acute and chronic pain; however, more robust randomized control studies are needed.
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Interact Cardiovasc Thorac Surg · Oct 2013
Down syndrome and postoperative complications after paediatric cardiac surgery: a propensity-matched analysis.
The incidence of congenital heart disease is ~50%, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery. ⋯ After propensity matching Down syndrome was not associated with increased mortality or complication rate following congenital cardiac surgery.
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Interact Cardiovasc Thorac Surg · Oct 2013
Association of perioperative troponin and atrial fibrillation after coronary artery bypass grafting.
Prediction of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) may lead to preventive or early treatment and improved outcome. We investigated the association of serial perioperative cardiac troponin T (cTNT) measurements with postoperative AF in patients undergoing CABG. ⋯ Perioperative cTNT is univariably associated with postoperative AF after CABG, but not independently. Further, no clinically useful cut-off point for preventive or early treatment could be identified. Both perioperative cTNT and postoperative AF are associated with negative outcome and prolonged hospital stay.
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Interact Cardiovasc Thorac Surg · Oct 2013
Case ReportsBlunt traumatic aortic rupture of the proximal ascending aorta repaired by resection and direct anastomosis.
Traumatic aortic injury represents 15% of motor vehicle related deaths with death occurring at the scene in 85% of the cases. Aortic disruptions usually occur at the isthmus in a transverse fashion with all three of the aortic layers being involved. Herein, we report the case of a 68-year old man with no prior medical history who was struck by a vehicle while riding his bicycle. ⋯ The case here discussed demonstrates a rare presentation of blunt aortic injury. The proximal ascending aorta is an unusual site of transection following blunt trauma with few reports in the literature. We were able to repair the aorta with direct suture, thus avoiding the use of artificial material.