J Cardiovasc Surg
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Editorial Comment
Towards a tailor made treatment of thoraco-abdominal aneurysms!
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Obstructive sleep apnea (OSA) is not generally acknowledged as a perioperative risk factor. High incidence of Sleep disordered breathing has been noticed in patients with cardiovascular disease. The Sleep Heart Health Research Study Group found Apnea-Hypopnea indices (AHI) as modest as 1-10 to be associated with cardiovascular disease manifestations. Given the lack of data we chose to study the incremental risk of OSA in patients undergoing cardiac surgery. ⋯ | Increased risk for postoperative complications is suggested in patients with OSA undergoing cardiac surgery. This risk is underestimated on account of lack of awareness about the incidence of OSA in the general population and the cardiovascular population in particular, difficulties in clinical suspicion and diagnosis and limited use of polysomnography.
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The avoidance of cardiopulmonary bypass and aortic cross-clamping in patients possessing single ventricular physiology has potential advantages including preservation of ventricular and pulmonary functions; early extubation, decreased incidence of pleural effusions and decreased requirement of inotropic agents and blood products. In this study, we assessed the postoperative outcome of patients who have undergone extracardiac Fontan operation performed without cardiopulmonary bypass. ⋯ The extracardiac Fontan operation performed without cardiopulmonary bypass provides good results in short and midterm follow-up periods with improved postoperative hemodynamics.
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Randomized Controlled Trial
Effect of cold blood cardioplegia enriched with potassium-magnesium aspartate during coronary artery bypass grafting.
The aim of this investigation is to evaluate the effect of enriched with potassium-magnesium aspartate cold-blood cardioplegia on early reperfusion injury and postoperative arrhythmias in patients with ischemic heart disease undergoing coronary artery bypass grafting (CABG), using measurements of cardiac troponin I (CTnI), hemodynamic indexes and clinical parameters. ⋯ Cold blood cardioplegia enriched with potassium-magnesium aspartate is beneficial on reducing reperfusion injury.
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Antegrade selective cerebral perfusion (ASCP) is gaining widespread popularity in aortic arch surgery because it has been demonstrated to be an optimal technique of cerebral protection. This study demonstrates the clinical results of aortic arch repair with ASCP. ⋯ | Our results confirmed that ASCP is a safe method of brain protection allowing complex aortic repairs to be performed with good results in terms of hospital mortality and neurologic outcome. Cerebral perfusion time did not influence postoperative outcome. The use of moderate hypothermia avoided all undesirable effects of deep hypothermia.