Interactive cardiovascular and thoracic surgery
-
Interact Cardiovasc Thorac Surg · Jun 2013
Chest X-ray and electrocardiogram in post-cardiac surgery follow-up clinics: should this be offered routinely or when clinically indicated?
Many centres in the UK carry out routine chest X-ray (CXR) and/or electrocardiogram (ECG) when patients attend follow-up clinic after cardiac surgery. Current evidence to support this practice is weak. This study investigated the appropriateness of carrying out these investigations in the absence of clinical indication. ⋯ There is a strong correlation between clinical indication for CXR and/or ECG and management alterations. These investigations should be performed during the routine follow-up of adult cardiac surgical patients using a patient-centred approach based on signs and symptoms.
-
Interact Cardiovasc Thorac Surg · Jun 2013
The effect of retrograde autologous priming volume on haemodilution and transfusion requirements during cardiac surgery.
Many cardiac procedures using cardiopulmonary bypass (CPB) still require intraoperative transfusion. Retrograde autologous priming (RAP) has been introduced to decrease haemodilution and the blood transfusion rate. This study is designed to determine the influence or RAP on intraoperative haematocrit, transfusion and its clinical consequences. ⋯ Retrograde autologous priming is an effective adjunct to decrease the blood transfusion rate, coping with the CPB-related haemodilution and its adverse clinical effects. A RAP volume individualized to each patient offers most benefit as part of a multidisciplinary blood conservation approach.
-
Interact Cardiovasc Thorac Surg · Jun 2013
Routine postoperative chest X-ray is unnecessary following the Nuss procedure for pectus excavatum.
Pneumothorax is the most common complication after the Nuss procedure for pectus excavatum. The majority of pneumothoraces are small, and the patients have no symptoms. The aim of this study was to evaluate the necessity for routine chest X-ray immediately after surgery. ⋯ Only patients with respiratory symptoms after the Nuss procedure need a chest X-ray. A routine chest X-ray can be limited to the time of discharge where the position of the bar(s) is also checked.
-
Interact Cardiovasc Thorac Surg · Jun 2013
Case ReportsStaged repair for aortic arch reconstruction and intracardiac repair following bilateral pulmonary artery banding in 3 critical patients.
Bilateral pulmonary artery banding has been performed as a first palliation for hypoplastic left heart syndrome with a poor preoperative condition. We report 3 patients with aortic arch reconstruction and intracardiac repair following bilateral pulmonary artery banding in moribund patients after birth. ⋯ More than 75% of cerebral oxygenation may provide higher urinary output due to higher renal blood flow through collateral circulation. This technique reduces the risk of perioperative neurological damage.
-
Interact Cardiovasc Thorac Surg · Jun 2013
Aortic valve reconstruction with autologous pericardium for dialysis patients.
This study aimed to report on original aortic valve reconstruction for patients on dialysis. ⋯ Medium-term results are excellent. Since warfarin for dialysis patients becomes problematic, a postoperative warfarin-free status is desirable. Aortic valve reconstruction can provide patients with a better quality of life without warfarin.