Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 1999
Selective preoperative cardiac screening improves five-year survival in patients undergoing major vascular surgery: a cost-effectiveness analysis.
To evaluate the long-term outcomes (5-year survival) and cost-effectiveness of selective coronary revascularization before major vascular surgery. ⋯ Selective screening before vascular surgery may improve 5-year survival and be cost-effective. Neither routine noninvasive testing nor routine angiography appears to be cost-effective compared with currently accepted medical therapies.
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J. Cardiothorac. Vasc. Anesth. · Jun 1999
Efficacy of epsilon-aminocaproic acid in children undergoing cardiac surgery.
To compare coagulation test results, blood loss, and blood product transfusions between patients receiving prophylactic epsilon-aminocaproic acid (EACA) and a control group matched for age, resternotomy, and surgery in children undergoing cardiac surgery. ⋯ EACA reduced intraoperative blood loss but did not significantly decrease blood product transfusions. Lack of efficacy may be related to relative underdosing and should be further studied.
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To assess whether obesity is a risk factor for morbidity and mortality in patients undergoing elective coronary artery revascularization. ⋯ Obese patients had only minor complications after coronary artery surgery. The large body surface area because of obesity protects them against the hemodilution-related transfusion risk.
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J. Cardiothorac. Vasc. Anesth. · Apr 1999
Comparative StudyTransesophageal echocardiographic area and Doppler flow velocity measurements: comparison with hemodynamic changes in coronary artery bypass surgery.
Changes in transesophageal echocardiography (TEE)-derived Doppler flow velocities through the mitral valve and pulmonary veins occur after cardiopulmonary bypass and are believed to reflect left ventricular (LV) diastolic functional impairment. The aim of this study was to determine the time-coincidence between these Doppler flow velocity parameters, LV two-dimensional (2D) short-axis area measurements, and hemodynamic parameters in patients after coronary artery bypass grafting. ⋯ In patients with normal systolic ventricular function and no inotropic support, Doppler flow velocity patterns alone did not sufficiently reflect hemodynamic changes, whereas 2D LV area, especially EDA measurements, provided useful information about hemodynamically significant LV filling impairment.