European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Jun 2006
Axillary cerebral perfusion for arch surgery in acute type A dissection under moderate hypothermia.
Aortic arch surgery is still associated with increased mortality and morbidity especially in acute type A aortic dissection. Adequate brain protection is essential and commonly performed by either antegrade selective perfusion of the brachiocephalic arteries or an interval of profound hypothermic circulatory arrest. We present our experience for open aortic arch repair with continuous antegrade brain perfusion by means of direct cannulation of the right axillary artery, under moderate hypothermia in patients with acute type A aortic dissection. ⋯ The absence of any major permanent neurologic deficit or any visceral damages in our patients suggests that continuous moderate hypothermic cerebral perfusion, with an interval of circulatory arrest of the lower body, is adequate for acute type A aortic dissection surgery, allowing safe open repair of the distal aortic arch.
-
Eur J Cardiothorac Surg · Jun 2006
Multicenter StudyEffect of risk-adjusted, non-dialysis-dependent renal dysfunction on mortality and morbidity following coronary artery bypass surgery: a multi-centre study.
As little is known about the impact of non-dialysis-dependent renal dysfunction on short- and mid-term outcomes following coronary surgery we have conducted a large multi-centre study comparing patients with no history of renal dysfunction to those with preoperative renal dysfunction. ⋯ Patients undergoing coronary surgery with non-dialysis-dependent renal dysfunction have significantly increased perioperative morbidity and mortality. Mid-term survival is also significantly reduced at 5-years.
-
Eur J Cardiothorac Surg · Jun 2006
Comparative StudySympathetic stimulation increases the blood flow through the in situ right gastroepiploic artery graft after off-pump coronary artery bypass graft surgery.
The right gastroepiploic artery is gaining popularity as an in situ arterial graft for coronary artery bypass surgery. Unlike the internal thoracic artery, the right gastroepiploic artery is a visceral artery and has a vasoconstrictive tendency in response to sympathetic stimulation. We hypothesized that blood flow through the in situ right gastroepiploic arterial graft might be compromised after sympathetic stimulation. ⋯ Sympathetic stimulation increases, rather than compromises, blood flow through the right gastroepiploic artery graft after coronary revascularization.
-
Eur J Cardiothorac Surg · Jun 2006
Morbidity and mortality following acute conversion from off-pump to on-pump coronary surgery.
Many studies have described reduced morbidity in hospital and equivalent midterm outcomes with off-pump coronary artery bypass (OPCAB) surgery compared to conventional CABG (CABG-CPB). However, OPCAB is sometimes converted acutely to CABG-CPB. We describe the risk of acute conversion and compare patients' outcomes for acutely converted OPCAB with unconverted OPCAB and CABG-CPB. ⋯ Experienced OPCAB surgeons have a low risk of acute conversion. Acutely converted patients have a moderately increased risk of death and serious complications in hospital. These risks are difficult to quantify precisely because conversion is rare.
-
Eur J Cardiothorac Surg · Jun 2006
AIRFIX: the first digital postoperative chest tube airflowmetry--a novel method to quantify air leakage after lung resection.
Prolonged air leak after pulmonary resection is a common complication and a major limiting factor for early discharge from hospital. Currently there is little consensus on its management. The aim of this study was to develop and evaluate a measuring device which allows a simple digital bed-side quantification of air-leaks compatible to standard thoracic drainage systems. ⋯ The AIRFIX device for bed-side quantification of air-leaks has proved to be very simple and helpful in diagnosis and management of air-leaks after lung surgery, permitting drain removal without tentative clamping.