Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jan 2009
Randomized Controlled Trial Comparative StudyThe impact of allogenic red cell transfusion and coated bypass circuit on the inflammatory response during cardiopulmonary bypass: a randomized study.
This study is designed to determine and compare the effects of transfusion and coated circuits on the inflammatory response during cardiopulmonary bypass. ⋯ Allogenic red cell transfusion enhances inflammatory response during CPB; coated circuit systems have a limiting effect on this inflammatory reaction.
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Interact Cardiovasc Thorac Surg · Jan 2009
ReviewIs aortic valve-sparing operation or replacement with a composite graft the best option for aortic root and ascending aortic aneurysm?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether it is better to preserve the aortic valve in patients with aortic root or ascending aortic aneurysms. Altogether 380 papers were found using the reported search, of which 23 represented the best evidence to answer the clinical question. ⋯ Sixteen papers reported a 10-year reoperative-free survival from 54% to 98% for valve-sparing operations and 67-81% for replacement operations in two further studies. Six papers reported their 10-year freedom from re-operation as 75-97% for valve-sparing operations. Our findings suggest that the results of both techniques are excellent and comparable, and the operating surgeon may safely make his decision as to which technique to select based on patient factors and his own experience without compromising the long-term outcomes of the patient.
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Interact Cardiovasc Thorac Surg · Jan 2009
Changing risk of patients undergoing coronary artery bypass surgery.
The aim of the present study was to evaluate the changing risk of patients undergoing coronary artery bypass grafting (CABG). Residents of Oulu who underwent coronary angiography and/or revascularization from 1993 to 2006 formed the basis of this community-wide study. One thousand three hundred and forty-nine consecutive patients who underwent CABG have been included in the analysis on changing operative risk and results after CABG. ⋯ Despite the increased operative risk, off-pump coronary surgery was associated with lower immediate postoperative mortality rates. Contrary to on-pump surgery, immediate postoperative death occurred after off-pump surgery only in patients with additive EuroSCORE >or=6. The results of this study suggest that improved perioperative care as well as changes in operative strategy are positively faced with the increased burden of comorbidities and operative risk of patients currently undergoing CABG.
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Interact Cardiovasc Thorac Surg · Jan 2009
Case ReportsNon-invasive positive pressure ventilation for bilateral diaphragm paralysis after pediatric cardiac surgery.
We present the case histories of two children having respiratory failure due to bilateral diaphragm paralysis after cardiac surgery. In both children non-invasive positive pressure ventilation alleviated respiratory distress, improved gas exchange, and prevented the need for endotracheal intubation. Following unilateral recovery of diaphragmatic function both children were successfully weaned from non-invasive positive pressure ventilation.