Journal of cardiac surgery
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The coronavirus disease (COVID) pandemic and the decision-making process of whether to perform urgent procedures during a surge are issues that will likely not disappear in the near future as reflected by the current rise in COVID cases in the southern and western United States and the resurgent numbers of confirmed cases around that world leading to are leading to new lock-downs. Multi-disciplinary discussions will continue to be important to decide individual risk and benefit profiles for patients with asymptomatic COVID patients moving forward. While imperfect, this most recent study provides more insight to some of the risks that should be weighed in these discussions. Further prospective, longitudinal research and better understanding of the heterogeneity of the COVID positive patient will further enhance understanding the decision-making process in the cardiac surgical patient through these difficult times.
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Case Reports
COVID-19 patient bridged to recovery with veno-venous extracorporeal membrane oxygenation.
In severe cases, the coronavirus disease 2019 (COVID-19) viral pathogen produces hypoxic respiratory failure unable to be adequately supported by mechanical ventilation. The role of extracorporeal membrane oxygenation (ECMO) remains unknown, with the few publications to date lacking detailed patient information or management algorithms all while reporting excessive mortality. ⋯ With proper patient selection and careful attention to hemodynamic management, ECMO remains a reasonable treatment option for patients with COVID-19.
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The coronavirus disease (COVID-19) has affected a large population across the world. Patients with cardiovascular disease have increased morbidity and mortality due to coronavirus disease. The burden over the health care system has to be reduced in this global pandemic to provide optimal care of patients with COVID-19, as well not compromising those who are in need of emergent cardiovascular care. ⋯ After reviewing a few available guidelines regarding cardiovascular surgery in COVID-19, we conclude to perform only those surgeries which cannot be deferred to a certain period of time, to reduce the burden of the health care system of the country, provide optimal care to patients with COVID-19, and to protect health care workers and cardiovascular patients from COVID-19.
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Case Reports
Successful treatment of thoracic aortic graft infection by omental flap following vacuum-assisted closure therapy.
Postoperative thoracic aortic graft infection (TAGI) is a serious and potentially fatal complication. The classical approach is to replace the infected graft. However, this approach has a high mortality rate. Alternatively, treatment of TAGI without graft replacement can be performed METHOD: Herein, we present a 72-year-old case with mediastinitis and graft infection after type A aortic dissection operation and successful treatment using omental flap coverage following vacuum-assisted wound closure therapy without graft replacement. ⋯ The patient had an uneventful postoperative course and remains infection-free to date.