J Cardiothorac Surg
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J Cardiothorac Surg · Jan 2013
Does the revised cardiac risk index predict cardiac complications following elective lung resection?
Revised Cardiac Risk Index (RCRI) score and Thoracic Revised Cardiac Risk Index (ThRCRI) score were developed to predict the risks of postoperative major cardiac complications in generic surgical population and thoracic surgery respectively. This study aims to determine the accuracy of these scores in predicting the risk of developing cardiac complications including atrial arrhythmias after lung resection surgery in adults. ⋯ In our cohort, RCRI and ThRCRI scores failed to accurately predict the risk of cardiac complications in patients undergoing elective resection of lung cancer. The British Thoracic Society (BTS) recommendation to seek a cardiology referral for all asymptomatic pre-operative lung resection patients with > 3 RCRI risk factors is thus unlikely to be of clinical benefit.
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J Cardiothorac Surg · Jan 2013
Case ReportsVeno-venous extracorporeal membrane oxygenation with a bicaval dual-lumen catheter in a SynCardia total artificial heart patient.
We report the case of a 55 years old caucasian male patient with cardiogenic shock due to an extended myocardial infarction who underwent SynCardia Total Artificial Heart implantation and veno-venous extracorporeal membrane oxygenation with a bicaval dual-lumen cannula for the treatment of adult respiratory distress syndrome.
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J Cardiothorac Surg · Jan 2013
Modified hypothermic circulatory arrest for emergent repair of acute aortic dissection type a: a single-center experience.
Deep hypothermic circulatory arrest (DHCA) with antegrade cerebral perfusion has been historically preferred for organ protection during surgical repair of the acute aortic dissection type A. However, in the past decades, different perfusion-specific strategies with a growing trend to increase the body temperature at circulatory arrest emerged. In this study, we retrospectively analyzed the clinical results of our modified protocol for cardiopulmonary bypass and hypothermia management. ⋯ Moderate hypothermia in combination with selective brain perfusion and systemic retrograde perfusion is associated with adequate cerebral and visceral protection, reduced postoperative complications and shortened intensive care unit stay in our series. This modified perfusion strategy may help in improving perioperative outcomes in this particular group of patients.
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J Cardiothorac Surg · Jan 2013
Efficacy of iloprost and montelukast combination on spinal cord ischemia/reperfusion injury in a rat model.
The thoracic or thoracoabdominal aortic aneurysm surgery may cause spinal cord ischemia because of aortic cross-clamping and may result in severe postoperative complications caused by spinal cord injury. Ischemia/reperfusion injury may directly or indirectly be responsible for these complications. In this study we sought to determine whether combination of iloprost and montelukast can reduce the ischemia/reperfusion injury of spinal cord in a rat model. ⋯ This study suggests that combined use of iloprost and montelukast may reduce ischemic damage in transient spinal cord ischemia and may provide better neurological outcome.
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J Cardiothorac Surg · Nov 2012
Protective effect of heparin in the end organ ischemia/reperfusion injury of the lungs and heart.
Ischemia/reperfusion (I/R) injury is harmful to the cardiovascular system and is responsible for the inflammatory response and multiple organ dysfunctions. In this study we investigated the effect of activated clotting time level on the aortic cross-clamping triggers a systemic inflammatory response and it effects to lungs and heart. ⋯ Heparin decreased remote organs injury on the lung and heart after ischemia/reperfusion of infra-renal section of the body in the rat model. So, we should be balance to act level for avoid to I/R injury per operative and early post operative period as providing ACT level nearly 200.