The Annals of thoracic surgery
-
Pulmonary arterial anastomotic stenosis is an unusual complication after single-lung transplantation. Intravascular ultrasound, performed at the bedside with an introducer sheath and guidewire, is a new technique that provides high-resolution tomographic images of the anastomotic site. This modality was used early in the postoperative course of a 58-year-old man to exclude significant pulmonary arterial anastomotic narrowing after right single-lung transplantation for primary pulmonary hypertension.
-
The purpose of this retrospective study is to determine the possible predictors of successful cardiac recovery using extracorporeal membrane oxygenation (ECMO) and the practical limits of ECMO support. ⋯ Postcardiotomy residual defects are a contraindication to ECMO. If children with residual defects are excluded, successful weaning from ECMO can be achieved in almost 70%, with almost all recovery occurring with the first 6 days of ECMO.
-
The known complications of prosthetic valve replacement in patients with an ascending aortic aneurysm and secondary aortic regurgitation who frequently have a morphologically normal aortic valve have prompted interest in valve-sparing aneurysm repair procedures. The aim of this study was to define the echocardiographic criteria for identifying suitable candidates for ascending aortic aneurysm repair that spares the aortic valve. We also examined the perioperative and intermediate-term results of this innovative procedure. ⋯ In selected patients undergoing ascending aortic aneurysm repair who have normal aortic leaflets but secondary aortic regurgitation, the native valve can be spared through this novel operation. The aortic annulus size is reduced significantly, thereby effectively eliminating hemodynamically significant aortic regurgitation. The intermediate-term results are promising, but the long-term durability of this type of repair needs to be determined.
-
The indications for prolonged cardiopulmonary support or extracorporeal membrane oxygenation are expanding. A potential serious complication of these techniques is distal limb ischemia. ⋯ We describe a simple method of providing distal limb perfusion using ordinary pressure tubing and a standard cordis catheter. This technique is capable of reproducing normal superficial femoral artery blood flow.
-
Randomized Controlled Trial Clinical Trial
Cardiopulmonary bypass perfusion temperature does not influence perioperative renal function.
The recent introduction of normothermic cardiopulmonary bypass (CPB) perfusion has raised concerns regarding the associated risk of renal dysfunction through its potential to exacerbate the systemic inflammatory response and end-organ injury. This study was designed to investigate the influence of CPB perfusion temperature on renal function. ⋯ These data suggest that cardiopulmonary bypass perfusion temperature does not influence renal function in patients undergoing coronary artery bypass grafting.