The Annals of thoracic surgery
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Randomized Controlled Trial Clinical Trial
Inhibition by dipyridamole of neutrophil adhesion to vascular endothelium during coronary bypass surgery.
Release of reactive oxygen radicals by activated neutrophils and neutrophil adhesion to endothelial cells have been observed after cardiopulmonary bypass. The aim of the present study was to evaluate the effects of preoperative dipyridamole treatment on neutrophil superoxide anion generation and endothelial cell-neutrophil interactions. ⋯ Our study demonstrated that preoperative treatment with oral dipyridamole significantly reduces both neutrophil superoxide anion generation and extent of neutrophil adhesion to endothelial cells after coronary bypass grafting procedures with cardiopulmonary bypass. The mechanism is probably mediated by endogenous adenosine.
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Epsilon-aminocaproic acid is routinely used to reduce bleeding during cardiac surgery. Anecdotal reports of thrombotic complications have led to speculation regarding this drug's safety. We investigated the association between epsilon-aminocaproic acid administration and postoperative stroke. ⋯ This series suggests that epsilon-aminocaproic acid administration does not increase the risk of postoperative stroke.
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Two patients with an inverted left atrial appendage after cardiac surgery were presented. Magnetic resonance imaging is one of the useful methods to establish an accurate diagnosis of this complication. In 1 patient, it repaired spontaneously without surgical intervention.
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Hypoxemia usually occurs after thoracotomy, and respiratory failure represents a major complication. ⋯ These results suggest that the degree of chronic obstructive pulmonary disease in lobectomy and impairment of preoperative breathing pattern in pneumonectomy are the main factors of respiratory failure after lung resection.
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We encountered a rare complication of mitral valve replacement with the CarboMedics prosthesis: a "stuck" leaflet detected by transesophageal echocardiography even though weaning from cardiopulmonary bypass had been uneventful. The patient was immediately managed without significant problems. We emphasize the importance of performing routine intraoperative transesophageal echocardiography in valve replacement as well as in valve repair, from the initial phase of operation.