European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Operating in a day surgery unit has potential benefits, including lower risk of cancellation, reduced infection rates, cost effectiveness and increased patient satisfaction. We believe that we are the first unit in the UK to regularly perform thoracic surgery in a dedicated day surgery unit, and describe our experience to date. ⋯ Surgeons are continually trying to fast track increasingly complex procedures and, with good patient selection, thoracic surgery can be performed safely and effectively in day surgery units.
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Eur J Cardiothorac Surg · Jun 2011
Risk of acute kidney injury after minimally invasive transapical aortic valve implantation in 270 patients.
Contrast agent is a potential risk factor for acute kidney injury (AKI). Little is known about the incidence of contrast-induced nephropathy (CIN) after trans-apical aortic valve implantation (TA-AVI) and on the impact of contrast exposure during preoperative computed tomography (CT) scan and cardiac catheterization. ⋯ GFR improves after TA-AVI. Postoperative AKI and RRT depend on the amount of intra-operative contrast agent. These results strongly support the need for intra-operative tools to reduce contrast-agent exposition during TA-AVI.
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Eur J Cardiothorac Surg · Jun 2011
Controlled Clinical TrialClinical value of intra-operative transit-time flow measurement for coronary artery bypass grafting: a prospective angiography-controlled study.
Transit-time flow measurement (TTFM) is the most widely used method for intra-operative graft quality control in coronary artery bypass surgery. Although it may provide the opportunity for the surgeon to promptly revise the graft before the patient is discharged from the operating room, controlled clinical data on the ultimate usefulness of the TTFM are scarce. Clear cut-off values for when to revise grafts have not been set. ⋯ TTFM predicts graft failure within the 6 months after CABG. However, specific cut-off recommendations for when to revise a graft cannot be set on the basis of TTFM. The cut-off values suggested in the literature lead to unnecessary graft revisions in the majority of cases, and, on the other hand, many technical defects probably remain unnoticed. Better methods to assess the quality of coronary artery bypass grafts are needed.
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Eur J Cardiothorac Surg · Jun 2011
Omni-Stat (Chitosan) arrests bleeding in heparinised subjects in vivo: an experimental study in a model of major peripheral vascular injury.
To explore the effectiveness of Omni-Stat (Chitosan) in a model of major haemorrhage in the presence of clotting dysfunction. ⋯ The study supports the evidence that Omni-Stat (Chitosan) acts independently of classical clotting pathways and should be effective in patients with clotting dysfunctions, who suffer major haemorrhage. It also suggests the potential for a role in cardiac surgery.