J Cardiothorac Surg
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J Cardiothorac Surg · Jan 2012
Outcomes in cardiac surgery in 500 consecutive Jehovah's Witness patients: 21 year experience.
Refusal of heterogenic blood products can be for religious reasons as in Jehovah's Witnesses or otherwise or as requested by an increasing number of patients. Furthermore blood reserves are under continuous demand with increasing costs. Therefore, transfusion avoidance strategies are desirable. We describe a historic comparison and current results of blood saving protocols in Jehovah's Witnesses patients. ⋯ Cardiac surgery without transfusion in high-risk patients such as Jehovah Witnesses can be carried out with results equivalent to those of low risk patients. Recent advances in surgical techniques and blood conservation protocols are main contributing factors.
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J Cardiothorac Surg · Jan 2012
Endotracheal tube cuff pressure assessment maneuver induces drop of expired tidal volume in the postoperative of coronary artery bypass grafting.
Previous investigations reported that the cuff pressure (CP) can decrease secondary to the CP evaluation itself. However is not established in literature if this loss of CP is able to generate alterations on expired tidal volume (ETV). Therefore, the aim of this study was to evaluate the potential consequences of the endotracheal CP assessment maneuver on CP levels and ETV in the early postoperative of coronary artery bypass grafting (CABG). ⋯ The CP assessment maneuver promoted a significant decrease in CP values and occurrence of air leakage with reduction of ETV in the early postoperative of CABG.
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J Cardiothorac Surg · Jan 2012
Urgent surgical management for embolized occluder devices in childhood: single center experience.
In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. ⋯ Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.
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J Cardiothorac Surg · Jan 2012
Case ReportsAlveolar recruitment maneuver in refractory hypoxemia and lobar atelectasis after cardiac surgery: a case report.
This case report describes an unusual presentation of right upper lobe atelectasis associated with refractory hypoxemia to conventional alveolar recruitment maneuvers in a patient soon after coronary artery bypass grafting surgery. ⋯ In the present report, the unusual alveolar recruitment maneuver with PEEP 40 cm H2O showed to be safe and efficient to reverse refractory hypoxemia and uncommon atelectasis in a patient after cardiac surgery.
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J Cardiothorac Surg · Jan 2012
Case ReportsGiant intercostal aneurysm complicated by Stanford type B acute aortic dissection in patients with type 1 neurofibromatosis.
Vascular involvement is rare in neurofibromatosis type 1 (NF1). It is often missed because it is usually asymptomatic. We report a case of a 42 years old male with neurofibromatosis type 1 who presented with left back discomfort. ⋯ However, the procedure was complicated by Stanford type B acute aortic dissection. Stanford type B acute aortic dissection was medically managed and patient remained well after discharge. Fragile vascular nature was thought to be one of the causes of this unreported complication.