European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Feb 2015
Extracorporeal membrane oxygenation for refractory septic shock in adults.
The role of extracorporeal membrane oxygenation (ECMO) remains controversial in adult patients with refractory septic shock. We sought to describe the clinical outcomes of adult patients supported by ECMO during septic shock refractory to conventional treatment. ⋯ Survival to hospital discharge remained low in adult patients with refractory septic shock despite ECMO support. Our findings suggest that implantation of ECMO during refractory septic shock could be considered in patients with severe myocardial injury but should be avoided in patients who have received CPR.
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Eur J Cardiothorac Surg · Feb 2015
Extracorporeal membrane oxygenation support for complex tracheo-bronchial procedures†.
The published experience with advanced broncho-plastic procedures performed with extracorporeal membrane oxygenation (ECMO) support is very limited. We examined our results to assess the risks and benefits of this approach. ⋯ Based on this experience, we consider veno-arterial ECMO support as a safe and valuable approach for complex airway surgery.
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Eur J Cardiothorac Surg · Feb 2015
Older age at the time of the Norwood procedure is a risk factor for early postoperative mortality†.
The Norwood procedure is commonly used as first-step palliation in children with hypoplastic left heart syndrome or related congenital malformations. In most cases, the operation is carried out during the first week of life. Excessive pulmonary blood flow in univentricular physiology can soon lead to compromised cardiac function and pulmonary hypertension and could have an influence on postoperative outcomes. ⋯ Age older than 20 days seems to be an independent risk factor for early postoperative mortality and fatal events after the Norwood procedure. Long-persisting excessive pulmonary blood flow and preoperative cardiac decompensation can be the reason for postoperative lethal pulmonary hypertensive crisis and compromised ventricular function.
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Eur J Cardiothorac Surg · Feb 2015
Longer hospital stay after Fontan completion in the November to March period.
Initial evidence suggests that total cavopulmonary connection (TCPC) completion during winter is associated with prolonged pleural effusion and hospitalization. This study was carried out to review the impact of season of operation on short-term outcome after TCPC procedure. ⋯ TCPC surgery performed in the period between November and March is associated with increased morbidity, especially longer hospitalization. Given the elective nature of TCPC operation, this operation should be scheduled outside of the NM period if possible.
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Eur J Cardiothorac Surg · Feb 2015
The off-pump technique in redo coronary artery bypass grafting reduces mortality and major morbidities: propensity score analysis of data from the Japan Cardiovascular Surgery Database†.
The benefits of off-pump coronary artery grafting (OPCAB) have been demonstrated. Especially in patients with a high number of comorbidities, redo coronary artery bypass grafting (CABG) remains a difficult entity of CABG, because patients are likely to have multiple risk factors and often have diseased patent grafts with adhesions. The aim of the present study was to evaluate the effects of the OPCAB technique in redo CABG on mortality and morbidity using data from the Japan Cardiovascular Surgery Database (JCVSD). ⋯ The off-pump technique reduced early operative mortality and the incidences of major complications in redo CABG.