Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Comparative StudyThromboelastography with heparinase in orthotopic liver transplantation.
To investigate the role of heparin in the postreperfusion coagulopathy during liver transplantation with heparinase-guided thromboelastography. ⋯ Heparinase-treated thromboelastography offered compelling evidence for the presence of heparin-like activity after liver graft reperfusion. The objective evidence provided by this modification of thromboelastography-guided protamine administration and was useful in identifying one of the many potential causes of postreperfusion bleeding in patients undergoing OLT.
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Comparative StudyIntraoperative transesophageal echocardiography during noncardiac surgery.
To investigate the use and impact of transesophageal echocardiography (TEE) during noncardiac surgery. ⋯ It appears that TEE in patients undergoing noncardiac surgery is efficacious in rapidly disclosing new findings and information during periods of hemodynamic instability. It may have a significant impact on intraoperative patient management and may be beneficial in patients older than 66 years of age.
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Comparative StudyCerebral complications after coronary artery bypass and heart valve surgery: risk factors and onset of symptoms.
Cerebral complications continue to be a major cause of morbidity after cardiac surgery. Earlier studies have mainly focused on intraoperative events, but symptoms may also occur later in the postoperative period. The purpose of this study was to determine the incidence and risk factors of focal neurologic complications and timing of cerebral symptoms. ⋯ Cerebral complications may be delayed after cardiac surgery, suggesting causes of cerebral damage other than intraoperative events. Valve-surgery patients had the lowest incidence and patients with combined procedures had the highest incidence of cerebral complications. Advanced age, diabetes mellitus, and preexisting cerebrovascular disease increased the risk.
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Comparative StudyEffect of aortic cannula characteristics and blood velocity on transcranial doppler-detected microemboli during cardiopulmonary bypass.
Cerebral microemboli are responsible to a large extent for the neuropsychiatric deficits after cardiac surgery. Differences in cannula size during cardiopulmonary bypass (CPB) will result in different velocities of blood exiting the aortic cannula. This study determined whether the number of transcranial Doppler (TCD)-detected emboli in the middle cerebral artery (MCA) during CPB correlated with blood speed or the direction of flow as determined by the shape of the aortic cannula. ⋯ The choice of a straight or curved aortic cannula or of a 24F versus 22F cannula may not be important with respect to the number of cerebral microemboli.