The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Dec 2009
The impact of pre- and postoperative renal dysfunction on outcome of patients undergoing coronary artery bypass grafting (CABG).
Acute changes in renal function after elective coronary bypass surgery represent a challenging clinical problem. In this study, we evaluated perioperative risk factors for the development of postoperative renal dysfunction (PRD), and the impact of such an event on the perioperative course. Additionally, we investigated the influence of preoperatively mildly increased serum creatinine on perioperative mortality and morbidity. ⋯ Mild renal dysfunction preoperatively is an important predictor of outcome after CABG. In these patients, PRD dramatically increases mortality, morbidity and length of hospital stay.
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Thorac Cardiovasc Surg · Dec 2009
ReviewExtracorporeal life support - systems, indications, and limitations.
Extracorporeal life support is becoming increasingly popular with the miniaturization of the devices necessary for cardiac and pulmonary support. In the present report, the current systems, indications for placement and limitations are reviewed.
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Aim of this study was to determine the clinical characteristics, morbidity and mortality in patients with a sternum fracture (SF). ⋯ Isolated SFs are benign entities that can be safely managed with rest and analgesia. Associated injuries in patients with SF determine the morbidity and length of hospital stay.
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Infection of the sternoclavicular joint (SJI) is a rare problem accounting for approximately 1 % of cases of septic arthritis. Patients typically present with symptoms of localized pain lasting a period of several weeks with or without systemic signs of fever and chills. Confirmation is made by aspirating the joint, and broad spectrum antibiotics should be tailored to treat the identified organisms. SJI can be treated conservatively with intravenous antibiotics and repeat imaging, but surgical intervention is required if patients present with an abscess, osteomyelitis or mediastinitis.
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Thorac Cardiovasc Surg · Dec 2009
Case ReportsSimultaneous pulmonary embolectomy and aortic root replacement.
Massive pulmonary embolism (PE) is characterized by hypotension and cardiogenic shock due to right ventricular failure, and is associated with a high mortality rate. In this case study, we report a simultaneous pulmonary embolectomy and aortic root replacement in a 71-year-old woman with a known ascending aortic aneurysm who sustained a massive PE following a VATS left upper lobectomy for non-small cell lung cancer.