Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2021
Meta AnalysisModified ultrafiltration reduces postoperative blood loss and transfusions in adult cardiac surgery: a meta-analysis of randomized controlled trials.
Cardiopulmonary bypass in cardiac surgery has been associated with several deleterious effects including haemodilution and systemic inflammation. Modified ultrafiltration (MUF) has been well established in paediatric cardiac surgery in counteracting postperfusion syndrome. However, MUF is less commonly used in adult cardiac surgery. In this meta-analysis, we compared clinical outcomes in adult patients who underwent cardiopulmonary bypass with and without MUF. ⋯ MUF is a safe and feasible option in adult cardiac patients, with significant benefits including improved postoperative haematocrit, as well as reduced postoperative chest tube bleeding, transfusion requirements and duration of ICU stay.
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Interact Cardiovasc Thorac Surg · Aug 2020
Meta AnalysisIntravenous iron therapy for patients with preoperative iron deficiency or anaemia undergoing cardiac surgery reduces blood transfusions: a systematic review and meta-analysis.
The benefits of preoperative intravenous (IV) iron treatment in cardiac surgery patients with preoperative anaemia or iron deficiency have not been well-established. We performed a systematic review and meta-analysis to determine the effects of treating preoperative anaemia or iron deficiency with IV iron in adult cardiac surgery patients. ⋯ International prospective register of systematic reviews ID Number CRD42019122844.
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Interact Cardiovasc Thorac Surg · Sep 2019
Meta AnalysisReported outcomes after aortic valve resuspension for acute type A aortic dissection: a systematic review and meta-analysis.
In the majority of patients presenting with acute type A aortic dissection (AAD) complicated by aortic valve insufficiency, the aortic valve (AV) can be preserved by AV resuspension. A meta-analysis was performed to investigate the outcomes following AV resuspension for AAD. A systematic literature search for publications reporting outcomes after AV resuspension in AAD published between January 1998 and June 2018 was conducted. ⋯ The long-term durability of AV resuspension is excellent, with low rates of endocarditis and thromboembolism and bleeding. Root reoperation hazard has become acceptable in recent years. Preoperative aortic valve insufficiency grade exceeding 2+ is a predictor for root reoperation.
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Interact Cardiovasc Thorac Surg · Jun 2019
Review Meta AnalysisManual aspiration versus chest tube drainage in primary spontaneous pneumothorax without underlying lung diseases: a meta-analysis of randomized controlled trials.
Although primary spontaneous pneumothorax (PSP) is an extremely frequent pathology, there is still no clear consensus on the treatment for these patients. We performed a strict meta-analysis on the effectiveness of manual aspiration (MA) compared to chest tube drainage (CTD) for the treatment of PSP. ⋯ On the basis of the currently available literature, MA is advantageous in the treatment of PSP because of shorter hospital stays. The subgroup analysis also indicates that MA can provide a lower hospitalization rate than CTD with a tube size of >12 Fr or a water seal drainage system. However, there are no significant differences between the 2 interventions with respect to immediate success rate, 1-year recurrence rate, 1-week success rate, time of recurrence, chest surgery rate or complication rate.
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Interact Cardiovasc Thorac Surg · Jun 2019
Review Meta AnalysisRisk factors for vasoplegia after cardiac surgery: a meta-analysis.
Postoperative vasoplegia (PV) is a common haemodynamic disorder after cardiac surgery and is associated with high operative mortality. Preventive and potent therapeutic measures are critical to improve the outcome. Identification of risk factors for PV may increase awareness and prompt therapeutic action. Our objective was to pool the available evidence on the risk factors for PV in cardiac surgery and to perform a meta-analysis. ⋯ Patients with renal failure, higher use of red blood cell, longer and combined cardiac surgery procedures are at a higher risk for PV. Measures to promptly identify and treat PV in these patients should be considered.