The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Feb 2014
The Mosaic bioprosthesis in the aortic position: 17 years' results.
The Mosaic bioprosthesis (Medtronic Inc., Minneapolis, Minnesota, United States), a stented porcine aortic valve, combines glutaraldehyde fixation with zero-pressure, root-pressure techniques and antimineralization treatment with amino-oleic acid for improved hemodynamics and tissue durability. The first device has been implanted worldwide at the authors' institution in September 1993. The aim of the present study was to collect mid- to long-term data of the prosthesis. ⋯ Performance and late outcome of the Mosaic bioprosthesis was satisfactory during 17 years after clinical introduction. The Mosaic bioprosthesis showed low incidence of SVD or need for reoperation in the long term.
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Thorac Cardiovasc Surg · Dec 2013
Comparative StudyMortality prediction after cardiac surgery: blood lactate is indispensible.
Blood lactate is accepted as a mortality risk marker in intensive care units (ICUs), especially after cardiac surgery. Unfortunately, most of the commonly used ICU risk stratification scoring systems did not include blood lactate as a variable. We hypothesized that blood lactate alone can predict the risk of mortality after cardiac surgery with an accuracy that is comparable to those of other complex models. We therefore evaluated its accuracy at mortality prediction and compared it with that of other widely used complex scoring models statistically. ⋯ Blood lactate accurately predicts mortality at both individual patient risk and patient cohort levels. Its precision is higher than that of other commonly used "complex" scoring models. The proposed LacScale is a simple and highly reliable model. It can be used (at bedside without electronic calculation) as such or integrated in other models to increase their accuracy.
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Thorac Cardiovasc Surg · Dec 2013
Observational StudyContinuing aspirin causes higher drainage even under full protection with antifibrinolytics.
The purpose of this study was to assess the impact of continuation of aspirin on bleeding complications following coronary artery bypass grafting (CABG) surgery operated by a single surgeon. ⋯ Continuing aspirin before CABG is associated with increased blood loss even when used in small doses and under full cover of antifibrinolytic agents. However, this blood loss is not harmful and does not negatively affect the patient's clinical progress.
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Thorac Cardiovasc Surg · Dec 2013
[Basic standards for a department of cardiac surgery. Quality requirements for the care of cardiac patients in connection with operations on the heart, the heart vessels and thoracic organ transplantation].
Current evolutions and substantial amendments of the German health care system in combination with distinguished progress in cardiac surgery over the past years require both a reflection of principles in patient-centered care and an update of basic standard requirements for a department of cardiac surgery in Germany. In due consideration of the data from the voluntary registry of the German Society for Thoracic and Cardiovascular Surgery, this article accurately defines core requirements for a cardiac surgical department (cardiac surgery on-site), subdivided into facilities, staff and processes. If based on these standards, one may anticipate that cardiac surgical care is performed under appropriate conditions leading to an intrinsic benefit for patients.
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Thorac Cardiovasc Surg · Dec 2013
Review Comparative Study Observational StudyThe predictive value of multiple electrode platelet aggregometry (multiplate) in adult cardiac surgery.
The purpose of this retrospective observational study is to analyze the value of multiple electrode platelet aggregometry (Multiplate analyzer, Verum Diagnostica, Munich) as a point-of-care (POC) device in adult cardiac surgical patients. ⋯ The ADPtest and the TRAPtest significantly predict the requirement of perioperative blood transfusion. Therefore, multiple electrode platelet aggregometry is beneficial for POC testing in cardiac surgical patients. Prospective, randomized, and controlled clinical studies are rare.