J Cardiothorac Surg
-
J Cardiothorac Surg · Jan 2015
Review Meta Analysis Comparative StudyHybrid coronary revascularization versus coronary artery bypass grafting for multivessel coronary artery disease: systematic review and meta-analysis.
The concept of hybrid coronary revascularization (HCR) combines the left internal mammary artery (LIMA)-left anterior descending (LAD) graft and percutaneous coronary intervention (PCI) to non-LAD vessels. Multiple comparative studies have evaluated the safety and feasibility of HCR and coronary artery bypass grafting (CABG) for multivessel coronary artery disease (MCAD). However, the sample size of each study was small, and evidences based on single-institutional experience. The purpose of this meta-analysis was to compare the short-term outcomes of HCR with those of CABG for MCAD. ⋯ Our meta-analysis indicates that HCR is feasible, safe and effective for the treatment of MCAD, with similar in-hospital and one-year follow-up outcome, significantly lower requirement of RBC transfusion, and faster recovery compared with CABG.
-
J Cardiothorac Surg · Jan 2015
Observational StudyHigh mobility group box 1 gene polymorphism is associated with the risk of postoperative atrial fibrillation after coronary artery bypass surgery.
The inflammatory response triggered by cardiac surgery with cardiopulmonary bypass (CPB) is a primary cause of postoperative atrial fibrillation (POAF). The objective of this study was to determine the relationships between rs2249825 (C/G) polymorphism in high-mobility group box protein 1 (HMGB1) and POAF in patients who underwent coronary artery bypass grafting (CABG) under CPB. ⋯ The HMGB1 rs2249825 was associated with the susceptibility to POAF after CABG with CPB in a Chinese Han population.
-
J Cardiothorac Surg · Jan 2015
Impact of malnutrition on postoperative delirium development after on pump coronary artery bypass grafting.
Even though malnutrition is frequently observed in cardiac population outcome data after cardiac surgery in malnourished patients is very rare. No thorough research was done concerning the impact of malnutrition on neuropsychological outcomes after cardiac surgery. The aim of our study was to analyze the incidence of postoperative delirium development in malnourished patients undergoing on pump bypass grafting. ⋯ Preoperative malnutrition is common in patients undergoing elective coronary artery bypass grafting. Nutrition deprivation is associated with early postoperative delirium after on pump coronary artery bypass grafting.
-
J Cardiothorac Surg · Jan 2015
Does percutaneous dilatational tracheostomy increase the incidence of sternal wound infection - a single center retrospective of 4100 cases.
The impact of percutaneous dilatational tracheostomy (PDT) on the development of post-median sternotomy wound infection (SWI) and mediastinitis is still controversial. We aimed to investigate the frequency of cross-infection and incidence of SWI after PDT. ⋯ There was a high incidence of microbial cross-infection from the PDTs to the sternal wounds in our study. We did not detect any correlation between the time of performing PDT and occurrence of SWI. According to our data, PDT seems to increase the incidence of SWI, especially caused by Candida spp., after cardiac surgery, which results in a prolonged hospital stay. Therefore, early antifungal prophylaxis after a PDT might be reasonable in high-risk patients on long-term mechanical ventilation if there is an impending SWI.
-
J Cardiothorac Surg · Jan 2015
Case ReportsContralateral reexpansion pulmonary edema with ipsilateral collapsed lung after pleural effusion drainage: a case report.
Reexpansion pulmonary edema is a rare but potentially life-threatening condition that occurs when a collapsed lung reexpands, usually in the same side of collapsed lung. We present a rare case in which a 57-year-old Korean man had a large amount of malignant pleural effusion. After undergoing tube thoracostomy drainage for the pleural effusion, a contralateral reexpansion pulmonary edema developed while the ipsilateral lung was half collapsed. ⋯ After conservative treatment with oxygen therapy, steroid administration, and negative suction application (suction pressure of -20 cm H2O) in the right pleural cavity for five days, the right lung could be fully expanded without development of reexpansion pulmonary edema, and the reexpansion pulmonary edema in the left lung resolved. Although it is a very rare condition, it is important to know that contralateral occurrence of reexpansion pulmonary edema can occur, especially when the ipsilateral lung is collapsed. Being aware of this potential condition can allow for early and proper management.