J Cardiothorac Surg
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J Cardiothorac Surg · Aug 2020
Perioperative observations of different bypass modes of a right coronary system based on instantaneous blood flow during the operation.
With the ageing of China's population, the incidence and mortality of coronary atherosclerotic heart disease (CAD) is increasing year by year, which brings a heavy burden to the family and society [1]. We aimed to analyse the strategy of coronary artery bypass grafting (CABG) in the right coronary artery and to compare the haemodynamic characteristics of the sequential grafts with those of single grafts and to observe the patency rate of those grafts for 1 week after the operation. ⋯ In our centre, the most common form of CABG in the right coronary artery system is a non-sequential vein bridge to the PDA. Whether there are sequential grafts of the PDA-PL or other sequential grafts among the different coronary artery systems, the instantaneous flow of a group of sequential grafts is higher than that of a single graft. DF in the group of sequential grafts of the right coronary system was better than that in the non-sequential group.
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J Cardiothorac Surg · Aug 2020
The role of the axillary Impella 5.0 device on patients with acute cardiogenic shock.
Acute cardiogenic shock is associated with high mortality rates. The Impella device is a microaxial left ventricular assist device that can be inserted through the axillary artery. The purpose of our study is to determine the role of the Axillary Impella devices on patients with acute cardiogenic shock. ⋯ A total of 58% (N = 23) of the study patients had previous mechanical support and 23% (N = 9) were on ECMO demonstrating the severity of disease and accounting for the high mortality. The Axillary Impella device allows for a minimally invasively placed device that is durable with a mean duration of 3 weeks. The Axillary artery Impella 5.0 provides upgraded full cardiac support while allowing for mobilization of the patient. In addition, it treats LV distention in patients on ECMO while avoiding sternotomy. Finally, the Axillary Impella provides time for decision making for explant, additional therapy with either long-term devices or orthotopic heart transplant.
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J Cardiothorac Surg · Jul 2020
Influence of chronic kidney disease on early clinical outcomes after off-pump coronary artery bypass grafting.
Patients with chronic kidney disease (CKD) have a high incidence of coronary heart disease, which is the leading cause of death in these patients. Coronary artery bypass grafting (CABG) significantly increases short-term mortality and decreases long-term mortality in patients with CKD compared with percutaneous coronary intervention (PCI). The effect of CKD on the early outcomes of off-pump CABG is not well-studied. We aimed to investigate the effect of CKD on early postoperative mortality and complications following off-pump CABG. ⋯ Patients with CKD had more preoperative complications, and their postoperative 30-day mortality and complication rates after off-pump CABG were significantly higher than those of patients with normal renal function. For CABG patients with CKD, the risk of surgery should be assessed carefully, and comprehensive measures should be taken to strengthen perioperative management, with an aim to reduce complications and mortality and improve surgical outcomes.
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J Cardiothorac Surg · Jul 2020
Acute kidney injury following on-pump or off-pump coronary artery bypass grafting in elderly patients: a retrospective propensity score matching analysis.
This single-centre, retrospective propensity score matching (PSM) study designed to study the impact of cardiopulmonary bypass (CPB) on postoperative acute kidney injury (AKI) and the relationship between AKI and long-term outcomes in elderly patients undergoing coronary artery bypass grafting (CABG). ⋯ For elderly CABG patients, AKI was common, but deterioration of dialysis was a seldom incidence. Comparing with on-pump, off-pump did not decrease the rates or severity of AKI, long-term new onset of dialysis or mortality. AKI was associated with an increased long-term new onset of dialysis and decreased long-term survival.
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J Cardiothorac Surg · Jul 2020
Letter Case ReportsPenetrating lung injury during Nuss procedure for pectus excavatum.
Life-threatening complications including cardiac perforation by the clamp or pectus bar during Nuss procedure have rarely been occurred. A rare case of lung entrapment between the pectus bar and chest wall after Nuss procedure was also reported. ⋯ And we agree with Mennie et al. who concluded thoracoscopic vision during Nuss procedure reduces the risk of major complication. In addition, we would like to emphasize to keep in mind what to check for routines with thoracoscopy during Nuss procedure.