Journal of cardiac surgery
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Comparative Study
Effects of inhaled nitric oxide following lung transplantation.
Lung transplantation offers an established therapeutic option for end-stage lung disease. It is associated with several complications, and early allograft failure is one of the most devastating among all. Different studies are focused on an attempt to minimize these complications, especially transplant failure. We aimed to evaluate the effects of inhaled nitric oxide (iNO) treatment in patients receiving lung transplantation. ⋯ Nitric oxide inhalation for the prevention and treatment of early allograft failure in lung transplant recipients is encouraging. It is superior to other vasodilators with its selectivity to the pulmonary vasculature, while having no significant side effects on systemic circulation. It appears to improve gas exchange and oxygenation properties. Further prospective randomized studies will aid to standardize inhalation nitric oxide therapy.
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Comparative Study
The impact of intraaortic balloon counterpulsation on bypass graft flow in patients with peripheral ECMO.
Numerous reports have been performed to investigate the hemodynamic effects of intraaortic balloon pumping (IABP) and nonpulsatile circulatory extracorporeal membrane oxygenation (ECMO), but studies on its impact on coronary artery bypass graft flow during concomitant use of IABP and ECMO are lacking. The aim of this study was to assess the impact of additional IABP support on the degree of blood flow increase in bypass grafts in high-risk patients with nonpulsatile femoral venoarterial ECMO. ⋯ We conclude that IABP-induced pulsatility significantly improves coronary bypass graft flows during nonpulsatile peripheral ECMO.
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Echocardiographic evaluation of anomalous pulmonary venous connection (APVC) may be difficult especially in patients with complex congenital heart diseases. Angiography may also be hazardous in sick patients. ⋯ We have presented a patient, operated with the diagnosis of partial APVC to the azygous vein. In this patient the diagnosis was suspected by echocardiography and confirmed by using three-dimensional computed tomography with angiography.
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The continued need to minimize blood product usage both during and after cardiac surgical procedures has been challenged by a changing patient population, and most recently by the withdrawal of the antifibrinolytic aprotinin (Trasylol, Bayer Pharmaceuticals, West Haven, CT, USA) from the market. To meet these challenges, a variety of topical hemostatic tools have continued to emerge in the surgical armamentarium. ⋯ Optimal application of novel topical adjuncts can be limited due to the lack of clarity on how to differentiate between these adjunctive hemostatic products and their appropriate uses. This paper will review the classes of these products, how and where such products can be used during cardiovascular surgery for achieving hemostasis, and the potential for improved outcomes through the appropriate selection and use of these agents.
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Comparative Study
Axillary artery cannulation for cardiopulmonary bypass during surgery on the ascending aorta and arch.
Performing axillary artery cannulation, during cardiopulmonary bypass in patients with an atherosclerotic ascending aorta or acute dissection of the ascending aorta and arch, is of growing interest. Our aim is to present our experience, to describe the surgical technique, and to demonstrate the sufficient cerebral and total body perfusion through axillary artery cannulation. ⋯ Antegrade cerebral perfusion is of paramount importance in cases of aortic atherosclerosis or aortic dissection. The axillary artery provides an excellent site for safe antegrade perfusion, which may play a role in preventing stroke.