Asian cardiovascular & thoracic annals
-
Asian Cardiovasc Thorac Ann · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialDose comparison of tranexamic acid in pediatric cardiac surgery.
To compare different doses of tranexamic acid, 150 consecutive children with congenital cyanotic heart disease were randomly assigned to one of 5 groups of 30 each. Group A served as a control. Group B received 50 mg.kg(-1) of tranexamic acid at induction of anesthesia. ⋯ The control group had the longest sternal closure time, the greatest blood loss in the first 24 hours, and the highest requirements for blood and blood products. Among the 4 groups given tranexamic acid, group D (triple dose) had the best results, followed by group E (double dose). Group B (single dose) had the worst results among the groups receiving tranexamic acid.
-
Asian Cardiovasc Thorac Ann · Jun 2004
Review Case ReportsDelayed cardiac tamponade after penetrating thoracic trauma.
Acute cardiac tamponade is very common after penetrating injuries to the chest. However, delayed cardiac tamponade is a rare phenomenon that may appear several days after injury. This paper presents three cases of delayed cardiac tamponade diagnosed weeks after ice pick wounds to the back. These experiences and a review of the literature on the subject are discussed.
-
Asian Cardiovasc Thorac Ann · Jun 2004
Comparative StudyHuman leukocyte antigens in hypertrophic cardiomyopathy patients in South India.
Hypertrophic cardiomyopathy is characterized by massive ventricular hypertrophy, reduced diastolic function, and excessive ventricular contraction. The human leukocyte antigens HLA-A, HLA-B, and HLA-DR were studied in 14 hypertrophic cardiomyopathy patients with left ventricular obstruction from South India. They were compared with 81 normal age- and sex-matched individuals from the same ethnic background. ⋯ The HLA-B51 and HLA-DR2 levels were significantly increased in hypertrophic cardiomyopathy patients compared to controls, whereas HLA-A19, HLA-B7, and HLA-DR4 were decreased when compared to the controls. It was noticed that haplotype B51-DR2-DQ3 was significantly associated with hypertrophic cardiomyopathy patients from South India. Hypertrophic cardiomyopathy may be associated with genes in the human leukocyte antigen region, and immunogenetic factors linked to human leukocyte antigens appear to play a major role in the pathogenesis.
-
Asian Cardiovasc Thorac Ann · Mar 2004
Comparative StudyActivated clotting time during cardiopulmonary bypass: is repetition necessary during open heart surgery?
We evaluated the need of activated clotting time monitoring and efficacy of heparinization protocol in 100 patients undergoing open heart surgery. Patients were anticoagulated with 300 or 400 units.kg(-1) heparin, based on their heparin sensitivity assessed at 5 min by activated clotting time. One-third of the initial dose was repeated at 90 min and thereafter hourly until completion of cardiopulmonary bypass. ⋯ No clot was observed in the surgical field or extracorporeal circuit. This anticoagulation protocol ensures adequate anticoagulation during hypothermic cardiopulmonary bypass. With this protocol, only one activated clotting time at 5 min after heparin administration is required and essential; subsequent monitoring is not necessary.
-
Asian Cardiovasc Thorac Ann · Mar 2004
Comparative StudyLung perfusion with oxygenated blood during aortic clamping prevents lung injury.
To evaluate the protective effect of continuous pulmonary perfusion with oxygenated blood during aortic crossclamping, 12 mixed-breed piglets (7-12 kg) were placed on cardiopulmonary bypass for 130 minutes. An experiment group of 6 (group E) had continuous pulmonary perfusion with oxygenated blood during cardiopulmonary bypass, while the other 6 served as controls (group C). Pulmonary function was measured at the beginning and end of cardiopulmonary bypass and one hour later. ⋯ There was preservation of the normal pulmonary parenchyma in group E, whereas group C had marked intra-alveolar edema and abundant intra-alveolar neutrophils. Anoxia of lung tissue during aortic crossclamping on cardiopulmonary bypass is probably the major factor in lung injury. Continuous pulmonary perfusion was effective in preventing lung injury during aortic crossclamping.