Journal of cardiac surgery
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Comparative Study
In which patients should sheathless IABP be used? An analysis of vascular complications in 1211 cases.
The purpose of our study is to compare the results of the sheathed and sheathless techniques for intraaortic balloon pump (IABP) insertion and to determine the rate of vascular complications in both conditions. ⋯ PAD, DM, and sheathed insertion technique are the major risk factors of ischemia during IABP use. Among all these risk factors, the only modifiable risk factor is the use of introducer sheath. With the presence of PAD and DM, the choice of sheathed method would increase the probability of ischemia almost 35 times. Sheathless method of insertion should be preferred in patients with DM and PAD.
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Internal thoracic artery (ITA) grafting to the left anterior descending artery (LAD) may have catastrophic consequences and can be fatal due to "ITA malperfusion syndrome." We have investigated the efficacy of a second graft in this syndrome. ⋯ Double supply to LAD using an additional saphenous vein graft is the treatment of choice for ITA malperfusion syndrome. The time interval between the first and the second grafts appears to be crucial for postoperative patient outcome.
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Comparative Study
Minimally invasive reoperative isolated valve surgery: early and mid-term results.
Minimally invasive, nonsternotomy approaches for valve procedures may reduce the risks associated with cardiac surgery after prior sternotomy and may improve outcomes. We analyzed our institutional experience to test this hypothesis. ⋯ Reoperative valve surgery can be safely performed using a nonsternotomy, minimally invasive approach, with at least equal mortality, less hospital morbidity, decreased hospital length of stay, and slightly favorable mid-term survival as compared to sternotomy.
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Case Reports
Iatrogenic coronary artery stenosis and late ventricular septal defect after penetrating cardiac trauma repair.
We report herein a 20-year-old male who has apical myocardial infarction due to suturing of the distal left anterior descending artery and late ventricular septal defect after penetrating cardiac trauma repair.
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Review Meta Analysis
Does the use of erythropoietin reduce the risk of exposure to allogeneic blood transfusion in cardiac surgery? A systematic review and meta-analysis.
The use of blood conservation techniques is important in cardiac surgery as postoperative bleeding is common and allogeneic blood transfusion carries the risk of transfusion reactions and infection transmission. Erythropoietin with and without preoperative autologous blood donation is one of the modalities to avoid allogeneic blood transfusion. The objective of this review was to assess the effectiveness of erythropoietin in reducing the risk of exposure to allogeneic blood transfusion during or after cardiac surgery. ⋯ The administration of erythropoietin before cardiac surgery is associated with a significant reduction in the risk of exposure to allogeneic blood transfusion. Further studies are warranted to define the patients' subgroups that may benefit the most from EPO administration.