J Cardiothorac Surg
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J Cardiothorac Surg · Mar 2013
Preoperative hospital length of stay as a modifiable risk factor for mediastinitis after cardiac surgery.
As high-risk cardiac patients frequently remain within hospital while waiting for surgery, the aim of the present study was to determine the role of preoperative length of hospital stay on mediastinitis, and also, to assess contemporary risk factors for this complication. ⋯ In addition to the traditional risk factors, prolonged preoperative hospital stay is also a significant and potentially modifiable predictor for the development of mediastinitis following cardiac surgery. All efforts should be made to minimize the delay in operating on hospitalized patients awaiting heart surgery.
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J Cardiothorac Surg · Feb 2013
Improving long term outcome for diabetic patients undergoing surgical revascularization by use of the radial artery conduit: a propensity matched study.
Diabetes predicts worse outcomes after coronary artery bypass grafting (CABG) We hypothesized that a strategy using radial artery (RA) conduit(s) would improve outcomes and long term survival for diabetic patients undergoing CABG with Left Internal Thoracic Artery (LITA) and RA grafts, with or without additional saphenous vein (SV) when compared with outcomes for patients bypassed with LITA and SV but no RA. ⋯ For diabetic patients having CABG with LITA, use of radial artery conduit adds a substantial and sustained survival advantage compared to LITA and vein. Optimal revascularization for diabetics with multi vessel disease is redefined.
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J Cardiothorac Surg · Feb 2013
Case ReportsMultiple paravalvular leak 17 years after a second mitral valve replacement.
Paravalvular leak (PVL) after prosthetic valve implantation is a significant complication and it usually occurs early in the postoperative period. We report a case of multiple PVL 17 years after the second mitral valve replacement without evidence of infection. ⋯ The sewing cuff was floated over the native annulus and large and multiple leakage was developed. The valve was easily removed and replaced with a new mechanical prosthesis.
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J Cardiothorac Surg · Jan 2013
Case ReportsEpicardial unipolar radiofrequency ablation for left ventricular aneurysm related ventricular arrhythmia.
We report a case of a 62-year-old Chinese man with typical triple-vessel lesions and apical left ventricular aneurysm accompanied with ventricular tachycardia. Off-pump coronary artery bypass (OPCAB) grafting was performed in combination with epicardial unipolar radiofrequency ablation and linear closure of left ventricular aneurysm. ⋯ The patient has been angina-free for 25 months since the operation and shows increasing exercise tolerance. Thus, left ventricular aneurysm plication combined with epicardial unipolar radiofrequency ablation during OPCAB may be beneficial for patients with ventricular aneurysm and preoperative malignant ventricular arrhythmia.
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J Cardiothorac Surg · Jan 2013
The use of neutrophil elastase inhibitor in the treatment of acute lung injury after pneumonectomy.
The prognosis of acute lung injury (ALI) after pneumonectomy is poor, with reported mortality rates of 30-100%. Neutrophil elastase inhibitor (NEI) is known to prevent lung injury caused by neutrophil elastase and improve lung function in ALI. We evaluated the effect of NEI on ALI after pneumonectomy. ⋯ We conclude that NEI may improve the lung function, shorten the duration of mechanical ventilation, and reduce mortality in patients with ALI after pneumonectomy.