J Cardiothorac Surg
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J Cardiothorac Surg · Jan 2006
Ischemia monitoring in off-pump coronary artery bypass surgery using intravascular near-infrared spectroscopy.
In off-pump coronary artery bypass surgery, manipulations on the beating heart can lead to transient interruptions of myocardial oxygen supply, which can generate an accumulation of oxygen-dependent metabolites in coronary venous blood. The objective of this study was to evaluate the reliability of intravascular near-infrared spectroscopy as a monitoring method to detect possible ischemic events in off-pump coronary artery bypass procedures. ⋯ Our initial results show that intravascular near-infrared spectroscopy can reliably be used for an online intraoperative ischemia monitoring in off-pump coronary artery bypass surgery. However, the method has to be further evaluated and standardized to determine the role of spectroscopy in off-pump coronary artery bypass surgery.
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J Cardiothorac Surg · Jan 2006
Case ReportsSecondary left ventricular injury with haemopericardium caused by a rib fracture after blunt chest trauma.
Trauma is the third most common cause of death in the West. In the US, approximately 90,000 deaths annually are traumatic in nature and over 75% of casualties from blunt trauma are due to chest injuries. Cardiac injuries from rib fractures following blunt trauma are extremely rare. We report the unusual case of a patient who fell from a height and presented with haemopericardium and haemothorax as a result of left ventricular and lingular lacerations and was successfully operated upon.
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J Cardiothorac Surg · Jan 2006
Randomized Controlled Trial Comparative StudyComparison of flow characteristics and vascular reactivity of radial artery and long saphenous vein grafts [NCT00139399].
The morphological and functional differences between arteries and veins may have implications on coronary artery bypass graft (CABG) survival. Although subjective differences have been observed between radial artery (RA) and long saphenous venous (LSV) grafts, these have not been quantified. This study assessed and compared the flow characteristics and in-vivo graft flow responses of RA and LSV aorto-coronary grafts. ⋯ The flow characteristics and flow responses of the RA graft suggest that it is a more physiological conduit than the LSV graft. The clinical relevance of the balance between imperfect patency versus the more physiological vascular function in the RA graft may be revealed by the 5-year angiographic follow-up of this trial.
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J Cardiothorac Surg · Jan 2006
Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting.
Patients who have prolonged stay in intensive care unit (ICU) are associated with adverse outcomes. Such patients have cost implications and can lead to shortage of ICU beds. We aimed to develop a preoperative risk prediction tool for prolonged ICU stay following coronary artery surgery (CABG). ⋯ A prediction tool has been developed which is reliable and valid. The tool is being piloted at our institution to aid resource management.