Journal of cardiac surgery
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The aim of this study is to determine the risk factors of delirium after cardiac surgery. ⋯ Postoperative delirium is related to several risk factors following cardiac surgery. Sedation with dexmedetomidine and fast-track weaning protocols may decrease the incidence of delirium in cardiac surgical patients.
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Advances in optics and instrumentation with the da Vinci S Surgical System have facilitated minimally invasive and robotic cardiac procedures including mitral valve repair and atrial myxoma excision. We report our retrospective data comparing robotically assisted myxoma excision with standard median sternotomy excision. ⋯ Robotic excision of atrial myxomas is safe and may be an alternative to traditional open surgery in selected patients.
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We report the use of fibrinogen/thrombin-coated equine collagen patch (Tachosil(®) ) as a sealant agent in six patients who underwent heart surgery for congenital heart disease (CHD) and developed an intraoperative lymphatic leakage detected at the time of surgery. The use of fibrinogen/thrombin-coated equine collagen patch proved to be safe and effective in preventing the development of postoperative chylothorax.
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Lung hernia is an uncommon diagnosis characterized by lung tissue protruding through a chest wall defect. It may occur spontaneously, as a congenital defect, as a result of trauma, or as a postsurgical complication. We describe the occurrence of lung hernia and subsequent successful herniorraphy in two patients following robotic-assisted mitral valve repair.
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Anticoagulation with heparin is recommended in patients with an intra-aortic balloon pump (IABP) to prevent thrombosis and embolization. However, anticoagulation increases the risk of bleeding, particularly in the early postoperative period after cardiac surgery. We investigated the safety of heparin-free management after IABP insertion in patients who underwent cardiac surgery. ⋯ In patients undergoing cardiac surgery with IABP support, the rate of thromboembolic complications was relatively low compared to historical controls. Heparin-free management may reduce the risk of hemorrhagic complications, with a low risk of thrombotic complications. Heparin should not be routinely used in patients requiring IABP after cardiac surgery.