European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Reinstitution of step-up care (recidivism) following cardiac surgery may be associated with increased mortality. This has, however, not been widely reported. ⋯ Patients are more likely to require recidivism following valve surgery+/-CABG than CABG alone. Whilst respiratory complications were the most common reasons for recidivism in our study, patients who required mechanical supports to maintain vital functions following surgery were most prone to recidivism. Hence, efforts should be made to treat cardio-respiratory problems early in this group of patients to reduce ICU recidivism.
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Eur J Cardiothorac Surg · Mar 2005
Pharmacological preconditioning with monophosphoryl lipid A improves post ischemic diastolic function and modifies TNF-alpha synthesis.
Pharmacologic preconditioning represents an attractive myocardial protection strategy. Tumor necrosis factor-alpha plays an important role in myocardial ischemia-reperfusion injury. We aimed to determine the effect of Monophosphoryl lipid A-induced delayed preconditioning on diastolic and systolic left ventricular function and tumor necrosis factor-alpha synthesis during ischemia and reperfusion. ⋯ Monophosphoryl lipid A-induced preconditioning renders the heart more tolerant to ischemia-reperfusion in terms of left ventricular diastolic and systolic function, and prevents tumor necrosis factor-alpha production during ischemia, through aborting the translation phase of tumor necrosis factor-alpha synthesis.
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Eur J Cardiothorac Surg · Mar 2005
Long-term outcomes of valve replacement with modern prostheses in young adults.
To examine the multiple impacts of valve replacement on the lives of young adults. ⋯ Late outcomes of modern prosthetic valves in young adults remain suboptimal. Bioprostheses deserve consideration in the aortic position, as mechanical valves are associated with lower physical capacity, a higher prevalence of disability, and poorer disease perception. Early surgical referral and atrial fibrillation surgery may improve survival after MVR.
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To predict risk factors of a prolonged air leak following pulmonary lobectomy. ⋯ Prolonged air leak is quite a common pulmonary complication after pulmonary lobectomy and can be treated conservatively. This complication significantly prolongs the length of hospitalization (P<0.01). We also conclude that COPD increases the risk of an air leak persisting for longer than 7 days.
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Eur J Cardiothorac Surg · Feb 2005
Surgical epicardial left ventricular lead versus coronary sinus lead placement in biventricular pacing.
Biventricular pacing has demonstrated improvement in cardiac function in treating congestive heart failure (CHF). Two different operative strategies (coronary sinus vs. epicardial stimulation) for left ventricular (LV) pacing were compared. ⋯ Surgical epicardial lead placement revealed excellent long-term results and a lower LV-related complication rate compared to CS-leads. Although, the approach via limited thoracotomy for biventricular pacing is associated with 'more surgery', it is a safe and reliable technique and should be considered as an equal alternative.