European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of inhaled nitric oxide with intravenous vasodilators in the assessment of pulmonary haemodynamics prior to cardiac transplantation.
Elevated pulmonary vascular resistance and transpulmonary gradient are predictors of increased perioperative mortality in patients undergoing orthotopic heart transplantation. Sodium nitroprusside and prostacyclin PGI2 are routinely used to assess the reversibility of pulmonary vascular resistance and transpulmonary gradient in heart transplant candidates, but their use is limited by their systemic vasodilatory effect. The aim of this study was to evaluate the systemic and pulmonary haemodynamic effects of low concentration (10 and 20 parts per million) inhaled nitric oxide in patients with severe heart failure with elevated transpulmonary gradient and pulmonary vascular resistance undergoing assessment for cardiac transplantation, and to compare the haemodynamic effects of inhaled nitric oxide with those of sodium nitroprusside and prostacyclin PGI2. ⋯ Low-concentration inhaled nitric oxide is as effective as sodium nitroprusside and prostacyclin in reducing transpulmonary gradient and pulmonary vascular resistance, and is highly pulmonary vasoselective.
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Eur J Cardiothorac Surg · Jan 1996
Predictive factors for postoperative cerebral complications in patients with thoracic aortic aneurysm.
Perioperative factors affecting the outcomes of postoperative brain function in patients with thoracic aortic aneurysm were demonstrated. ⋯ Although there was an increased incidence of advanced age and complex lesions in patients with aortic aneurysm, an improvement in surgical results has recently been achieved using advanced diagnostic and surgical techniques.
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Since 1990 the Institute of Cardiac Survey has compiled data on open heart surgery. In 1993 247,943 operations were performed. ⋯ This subset was 1.9%, e.g. 4,689, of the total number. The increasing rate of open heart surgery in Europe was 8.3%, whereby the highest increasing rate could be observed in CABG.
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Eur J Cardiothorac Surg · Jan 1996
Clinical Trial Controlled Clinical TrialThe effect of pentoxifylline on the lung during cardiopulmonary bypass.
Cardiopulmonary bypass (CPB) produces an inflammatory response due to the interaction of blood with a foreign body surface. The lungs are most affected by this inflammatory response. Pentoxifylline (PTX), a phosphodiesterase inhibitor and an inhibitor of leukocyte activation, is used to minimize damage in lungs where leukocytes play an important role. ⋯ The alveolar-arterial PO2 gradient increased after the CPB in both groups but a moderate decrease was observed 2 h postoperatively. In lung biopsy specimens taken before and after the CPB, there was marked leukocyte sequestration in the control group, whereas the number of leukocytes was seen to be insignificant in the PTX group (P < 0.005). This dosage regimen of PTX inhibits the postoperative increase in PVR and greatly minimized leukocyte sequestration in the lung due to CPB.
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Eur J Cardiothorac Surg · Jan 1996
Case ReportsInfected left atrial myxoma with concomitant mitral valve endocarditis.
Myxomas are the most common primary cardiac tumors. They may simulate infective endocarditis but are rarely infected. Currently, 17 infected left atrial myxomas have been reported in the literature [1, 7, 8, 10, 11]. We present a patient with infected left atrial myxoma combined with mitral valve endocarditis, treated by excision of the myxoma and mitral valve reconstruction.