J Cardiothorac Surg
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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
Temporary epicardial left ventricular and biventricular pacing improves cardiac output after cardiopulmonary bypass.
To evaluate, with different pacing modes, acute changes in left ventricular systolic function, obtained by continuous cardiac output thermodilution in various subsets of patients undergoing cardiopulmonary bypass surgery. Increments of mean arterial pressure and cardiac output were considered the end point. ⋯ Right atrial-right ventricular pacing generated adverse hemodynamic effects. Right atrium-left ventricular pacing produced significant CO improvement particularly in cases with depressed ventricular function and left bundle branch block. The greatest increments were observed with left ventricular or biventricular pacing in atrial fibrillation with depressed ejection fraction.
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J Cardiothorac Surg · Jan 2012
Hospital costs fell as numbers of LVADs were increasing: experiences from Oslo University Hospital.
The current study was undertaken to examine total hospital costs per patient of a consecutive implantation series of two 3rd generation Left Ventricle Assist Devices (LVAD). Further we analyzed if increased clinical experience would reduce total hospital costs and the gap between costs and the diagnosis related grouped (DRG)-reimbursement. ⋯ There were significant reductions in total hospital costs per patient as the numbers of patients were increasing. This can possibly be explained by a learning effect including better logistics, selection and management of patients.
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J Cardiothorac Surg · Jan 2012
Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study.
Right ventricular failure (RVF) and -support is associated with poor results. We aimed for a new approach of right - sided assistance bypassing the right ventricle and pulmonary circulation in order to better decompress the right ventricle and optimize left ventricular filling. ⋯ Bypassing the right ventricle and pulmonary circulation with an oxygenating assist device, which may offer the advantages of enhanced right ventricular decompression and augmented left atrial filling, is feasible and effective in the treatment of acute RVF. Long time experiments are needed.
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J Cardiothorac Surg · Jan 2012
Case ReportsA case report of para-esophageal bronchogenic cyst with esophageal communication.
Paraesophageal bronchogenic cyst was one of common mediastinal congenital cystic lesions of foregut origin. Because of an intimate embryologic relationship with the esophagus, they were usually found intramural (intramural esophageal bronchogenic cysts) with the local esophageal mucosa being intact and the paraesophageal bronchogenic cysts were rarely communicated with esophageal lumen. ⋯ The symptoms of chest pain and dysphagia were relieved immediately after operation. The follow-up was well 2 years after the surgery.