The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Sep 2014
Case ReportsTension subcutaneous emphysema during laparoscopic surgery treatment of colon cancer: a case report.
Carbon dioxide (CO2) insufflation is now essential for most endoscopic surgeries, such as abdominal, pelvic, and neck endoscopic surgery. It is not uncommon for CO2 leaks to occur unintentionally into subcutaneous tissue, later diffusing into a patient's bloodstream and resulting in hypercarbia. ⋯ Herein, we report on a case of tension subcutaneous emphysema and subsequent fatal ventilatory failure due to massive subcutaneous emphysema during laparoscopy. A timely blowhole incision is an effective intervention in an emergent setting like this case, although the patient had endotracheal intubation.
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Thorac Cardiovasc Surg · Aug 2014
Hematologic markers better predict left ventricular assist device thrombosis than echocardiographic or pump parameters.
Left ventricular assist device (LVAD) thrombosis is a life-threatening complication that remains a major clinical problem. Consensus diagnostic criteria do not exist. We investigated whether hematologic, echocardiographic, or pump parameters reliably change during LVAD thrombosis. ⋯ Hematological markers of hemolysis, but not echocardiographic or pump parameters, reliably changed during LVAD thrombosis. Markers of hemolysis are the best early predictors of LVAD thrombosis.
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Thorac Cardiovasc Surg · Jun 2014
Comparative StudyRace and survival among diabetic patients after coronary artery bypass grafting.
Diabetes is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined. ⋯ A survival disadvantage after CABG was not observed among black versus white diabetic patients in our study.
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Thorac Cardiovasc Surg · Jun 2014
Comparative StudyClinical performance of the EuroSCORE II compared with the previous EuroSCORE iterations.
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II has been recently introduced as an update to the previous versions. We sought to evaluate the predictive performance of the EuroSCORE II model against the original additive and logistic EuroSCORE models. ⋯ The EuroSCORE II might be considered a solid predictive tool for hospital mortality. Although, the EuroSCORE II employs more sophisticated calculation methods regarding the number and definition of risk factors included, it does not seem to significantly improve the performance of previous iterations.
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Thorac Cardiovasc Surg · Jun 2014
Comparative StudySurvival after major cardiac surgery: performance and comparison of predictive ability of EuroSCORE II and logistic EuroSCORE in a sample of Mediterranean population.
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II has been recently introduced to improve mortality prediction in cardiac surgery. We compare the predictive ability of the new EuroSCORE II with that of the original logistic EuroSCORE and we made an evaluation of a sample of our population submitted to major cardiac surgery in the context of a Mediterranean country. ⋯ Mortality in our population was higher than the mortality that would have been expected by the new EuroSCORE II analysis. Although EuroSCORE II has good calibration and discrimination capacity, both are worse than those demonstrated by logistic EuroSCORE. Forthcoming evaluations are necessary when the new model will be widely used.