The Annals of thoracic surgery
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Replacement of the aortic root with a composite graft containing a prosthetic mechanic valve is the preferred surgical procedure for tailoring the aortic root. The aim of this study is to determine the 5-year experience with the composite root replacement using our new modification of the Bentall technique. ⋯ The flanged composite graft offers excellent long-term results, with very low prevalence of prosthetic-related complications. The new created sinuses and the flange are especially helpful to continue physiologic function of the aortic root.
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Clinical Trial Controlled Clinical Trial
Effects of autologous platelet concentrate reinfusion after open heart surgery in patients with congenital heart disease.
Plasma pheresis and reinfusion of platelet-rich plasma has not been shown to reduce blood loss in cardiac patients. Recently, freshly prepared autologous platelet concentrates (PC) can be made from patient's blood and has a higher concentration than conventional platelet rich plasma. In this study, the effects of autologous PC reinfusion were examined after open heart surgery in patients with congenital heart disease. ⋯ Reinfusion of the freshly prepared autologous PC was followed by good aggregation responses and low blood loss in patients with noncyanotic congenital heart disease after open heart surgery. This procedure may be useful in pediatric open heart surgery without blood transfusion or with little administration of homologous blood products.
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Deterioration of gas exchange during one lung ventilation (OLV) is caused by both total collapse of the nondependent lung and partial collapse of the dependent lung. A previous report demonstrated that an alveolar recruitment strategy (ARS) improves lung function during general anesthesia in supine patients. The objective of this article was to study the impact of this ARS on arterial oxygenation in patients undergoing OLV for lobectomies. ⋯ Alveolar recruitment of the dependent lung augments PaO2 values during one-lung ventilation.