The Annals of thoracic surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
IL-6 and IL-8 levels after cardiopulmonary bypass are not affected by surface coating.
BACKGROUND.:Contact of blood with the surfaces of the cardiopulmonary bypass (CPB) circuit has been implicated as a cause of the inflammatory response. We undertook a prospective randomized trial of 200 pediatric patients, all with a calculated total bypass flow of less than 2.3 L/min (< 0.96 L/m2/min). ⋯ Albumin preprime and heparin-bonding do not attenuate the inflammatory response component attributable to the concentration of these markers.
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Atrial fibrillation is a common complication of early postoperative period in lung cancer thoracotomy. Its clinical incidence and short- and long-term impact on overall mortality has never been definitely assessed; moreover, it is unclear whether the arrhythmia represents an independent cardiac risk factor. ⋯ At our institution, early atrial fibrillation occurrence after operation for lung cancer does not show any negative impact on short- and long-term mortality or on recurrence rate.
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Cardiac operations frequently are complicated by postoperative cognitive decline. Less common and less studied is postoperative cognitive decline after noncardiac surgery, so we determined its incidence, severity, and possible predictors. ⋯ Cognitive decline after noncardiac operations is a frequent complication of surgical procedures. The severity could preclude successful return to a preoperative lifestyle.
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Coronary air embolism is a potential complication of cardiac operations performed with cardiopulmonary bypass, especially open heart operations. There are many recommended methods described in the literature to treat the sequelae of coronary air embolism, none universally effective. We describe a simple and safe method to treat the condition, which we have found very effective in our practice.
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We treated two cases of enlargement of ulcer-like projections in the descending thoracic aorta, which were recognized after emergency graft replacement from the ascending aorta to the aortic arch for acute type A aortic dissection. The intimal tear, which was near the left subclavian artery, was resected during the initial operation. Graft replacement of the descending thoracic aorta was successful.