European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2008
Logistic risk model predicting postoperative respiratory failure in patients undergoing valve surgery.
Previous studies have been unable to identify independent valve-related risk factors for postoperative respiratory failure (RF) in patients undergoing valve surgery. This study was designed to determine the incidence and predictors of RF in these patients. We also aimed to create a model based on these risk factors that could serve as a tool for the prediction of this complication. ⋯ Respiratory failure is a common complication particularly in patients undergoing complex valve operations such as endocarditis or multiple valve procedures. The independent predictors of RF including valve-related factors allowed us to create a predictive model with great accuracy. The poor long-term survival of patients with RF underlines the need to direct more resources towards prevention and treatment of this complication.
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Eur J Cardiothorac Surg · Nov 2008
Case ReportsUse of Argatroban for anticoagulation during cardiopulmonary bypass in a patient with heparin allergy.
The use of Argatroban for treatment of heparin-induced thrombocytopenia (HIT) and for percutaneous coronary intervention in patients with HIT is well described and FDA approved. The use of Argatroban for cardiopulmonary bypass remains off label and the subject of a few case reports. We report the case of a patient with a heparin allergy requiring cardiopulmonary bypass (CPB) for mitral valve replacement. Argatroban was successfully used as anticoagulation for CPB.
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Eur J Cardiothorac Surg · Nov 2008
Efficacy and safety of modified bilateral thoracoscopy-assisted Nuss procedure in adult patients with pectus excavatum.
Several modifications for increasing the efficacy and safety of the minimally invasive surgery (Nuss procedure) for repair of pectus excavatum in pediatric patients were presented. In this study, we apply a modified bilateral thoracoscopic approach to adapt the Nuss procedure to adult patients. ⋯ The modified bilateral thoracoscopy-assisted Nuss repair for adult patients could eliminate the risk of cardiopulmonary injuries. It could allow direct inspections in mediastinum and facilitate mediastinal dissection, especially in patients with recurrence, history of previous thoracic procedure or double-bar insertion. Other methods for ensuring safety such as substernal dissection or elevation may be unnecessary.