The Annals of thoracic surgery
-
A membrane oxygenator consisting of a microporous polypropylene hollow fiber with a 0.2-microm ultrathin silicone layer (cyclosiloxane) was developed. Animal experimental and preliminary clinical studies evaluated its reliability in bypass procedures. ⋯ This oxygenator is more durable and offers greater gas transfer capabilities than the previous generation of oxygenators.
-
Conventional coronary artery bypass grafting using cardiopulmonary bypass carries relatively high mortality and morbidity for patients with left ventricular dysfunction. ⋯ Coronary artery bypass grafting without cardiopulmonary bypass is a viable alternative to conventional coronary artery bypass grafting particularly for patients with extreme left ventricular dysfunction or those with coexisting risk factors, such as acute myocardial infarction and cardiogenic shock.
-
Pulmonary resection is rarely required for trauma, and its mortality is reportedly high. ⋯ Pulmonary resection is infrequently required for lung injury. Overall mortality is lower than previously reported, but pneumonectomy has a high mortality. Blunt trauma has a higher mortality than penetrating trauma. Injury severity scores are higher for nonsurvivors than survivors; this shows the importance of associated injuries on outcome.
-
Competitive status of percutaneous transluminal coronary angioplasty and stenting has stimulated an interest in minimally invasive direct coronary artery bypass grafting. ⋯ Minimally invasive direct coronary artery bypass grafting is safe and effective with good early and midterm clinical results, especially with left internal mammary artery-to-left anterior descending coronary artery grafting via minithoracotomy. Regional cardiac wall immobilization of coronary artery target sites enhances the early graft patency in a predictable manner (96.2%), and this method should be an essential part of all minimally invasive direct coronary artery bypass graft operations with left internal mammary artery-to-left anterior descending artery grafts via minithoracotomy. Further study is required to establish the long-term efficacy of minimally invasive direct coronary artery bypass grafting and the treatment of coronary artery disease.
-
Conventional reoperative coronary artery bypass grafting using cardiopulmonary bypass carries relatively high mortality and morbidity. ⋯ Reoperative coronary artery bypass grafting without cardiopulmonary bypass has acceptable early and midterm outcome, and should be considered a viable alternative for properly selected patients.