The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Leukoreduction program for red blood cell transfusions in coronary surgery: association with reduced acute kidney injury and in-hospital mortality.
Leukocytes in allogeneic blood transfusions cause several immunomodulatory events. This before-and-after cohort study evaluated clinical outcomes after adoption of prestorage leukoreduction program for blood transfusions, with particular focus on acute kidney injury. ⋯ Leukoreduction of allogeneic blood products is associated with decreased acute kidney injury and mortality in highly transfused patients.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Comparative StudyInfluence of timing of intraaortic balloon placement in cardiac surgical patients.
The study objective was to evaluate the association between timing of intraaortic balloon pump insertion and outcomes in patients undergoing cardiac surgery. ⋯ This study comparing outcomes in patients undergoing cardiac surgical procedures with timing of intraaortic balloon pump placement revealed that the use of preoperative intraaortic balloon pumps was associated with a strong trend toward reduction in in-hospital mortality despite a higher predicted mortality in this group. The study provides support to the growing body of literature advocating preoperative use of intraaortic balloon pumps in carefully selected patients.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Randomized Controlled Trial Comparative StudyA prospective, randomized trial comparing BioGlue and Vivostat for the control of alveolar air leak.
BioGlue (CryoLife, Europa Ltd, Surrey, UK) is effective in reducing alveolar air leak after pulmonary resection. However, concerns exist regarding the use of bovine-derived products. Vivostat (Vivostat A/S, Alleroed, Denmark) is an autologous fibrin sealant that confers certain advantages. It shows superior elastic properties, a faster absorption time, and the absence of risk of transmission of blood-borne diseases. ⋯ There were no significant differences in the 3 clinical outcome measures of duration of air leak, time to intercostal drain removal, and length of hospital stay in those patients receiving BioGlue or Vivostat. Given the inherent advantages of our institutional preference is to use Vivostat in the control of postoperative air leaks after pulmonary resection.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Comparative StudyNonelective cardiac surgery in the elderly: is it justified?
Elderly patients might be denied nonelective cardiac surgery because of the perception of poor outcomes and an unacceptable quality of life. In this study we evaluate long-term survival and quality of life in these patients. ⋯ Long-term survival and quality of life after nonelective cardiac surgery can equal that of the general elderly population. Age alone should not disqualify a patient for urgent or emergent cardiac surgery.