Interactive cardiovascular and thoracic surgery
-
Interact Cardiovasc Thorac Surg · May 2014
Optimal cut-off value for cardiac troponin I in ruling out Type 5 myocardial infarction.
The clinical classification of myocardial infarction (MI) into five types was introduced in 2007 as a component of the universal definition. A Type 5 MI was defined as a MI related to coronary artery bypass surgery. In a setting of patients undergoing elective coronary artery bypass grafting, we set out (i) to describe the pattern of multiple serial cardiac troponin I (cTnI) measurements within 72 h postoperatively and (ii) to determine the optimal cardiac troponin I cut-off value in ruling in or ruling out a Type 5 MI. ⋯ In clinically stable patients undergoing elective coronary artery bypass grafting, measurements of cTnI are useful in ruling out a Type 5 MI.
-
Interact Cardiovasc Thorac Surg · May 2014
Alveolar recruitment manoeuvre is safe in children prone to pulmonary hypertensive crises following open heart surgery: a pilot study.
To test the tolerance and safety of an alveolar recruitment manoeuvre performed in the immediate postoperative period of corrective open heart surgery in children with congenital heart disease associated with excessive pulmonary blood flow and pulmonary arterial hypertension due to left-to-right shunt. ⋯ The alveolar recruitment manoeuvre seemed to be safe and well tolerated immediately after open heart surgery in infants liable to pulmonary hypertensive crises.
-
Interact Cardiovasc Thorac Surg · May 2014
Frailty is a predictor of short- and mid-term mortality after elective cardiac surgery independently of age.
Assessment of perioperative risk of elderly patients in cardiac surgery is difficult, and most of the common risk scores show over- or underestimation. Two frailty scores, the comprehensive assessment of frailty (CAF) score and the Frailty predicts death One yeaR after CArdiac Surgery Test (FORECAST), were developed as additional tools to estimate the preoperative mortality risk, taking into consideration the frailty status of elderly patients. ⋯ CAF and FORECAST are additional tools to evaluate elderly patients adequately before elective cardiac surgery, and showed an association with short- and mid-term mortality independently of age.
-
Interact Cardiovasc Thorac Surg · May 2014
Safety considerations during transapical aortic valve implantation.
Transcatheter aortic valve implantation (TAVI) is a new method for the treatment of very high-risk patients with aortic valve stenosis. The radiation dose to which the patient and each member of the heart team are exposed during this new fluoroscopically guided intervention is unknown. ⋯ During a TA-TAVI procedure, the patients receive a higher X-ray dose than during coronary angiography with intervention. After 100 TAVI procedures, the members of the heart team sustain a comparable dose of ionizing radiation to the annual dose received by a busy interventional cardiologist. Therefore, maximal safety and optimal X-ray protection for patients and the members of the team are crucial and should be redefined.