The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2013
The effect of cardiopulmonary bypass prime volume on the need for blood transfusion after pediatric cardiac surgery.
There is increasing awareness that erythrocyte transfusions after pediatric cardiac surgery have deleterious effects. Despite reports of decreased transfusion requirements associated with smaller cardiopulmonary bypass circuits, the relationship between circuit prime volume and need for transfusion has not been systematically examined. ⋯ Perioperative need for transfusion in pediatric cardiac surgical patients is independently related to the prime volume of the cardiopulmonary bypass circuit. It therefore seems prudent to minimize circuit prime volumes to avoid unnecessary use of blood products.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Time in the stair-climbing test as a predictor of thoracotomy postoperative complications.
The stair-climbing test as measured in meters or number of steps has been proposed to predict the risk of postoperative complications. The study objective was to determine whether the stair-climbing time can predict the risk of postoperative complications. ⋯ The only variable showing association with complications, according to multivariate analysis, was stair-climbing time.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
A new nonocclusive laser-assisted coronary anastomotic connector in a rabbit model.
The Excimer laser-assisted nonocclusive anastomotic technique is a nonocclusive, facilitated bypass technique that is currently Conformité Européenne and Food and Drug Administration approved for clinical application in neurosurgery. In the present study, we assessed the safety and feasibility of a newly developed Excimer laser-assisted nonocclusive anastomosis-based prototype coronary anastomotic connector in an acute rabbit abdominal aortic bypass model before application in experimental coronary bypass surgery. In addition, 2 sealants were tested to facilitate anastomotic hemostasis in the current device prototype. ⋯ The results of the present study have demonstrated that the Excimer laser-assisted nonocclusive anastomotic connector is safe and reliable and can be efficiently applied in an acute rabbit abdominal aortic bypass model. Provided the limitations can be addressed, this easy-to-use and nonocclusive technique has the potential to facilitate minimally invasive coronary bypass surgery.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Effect of atherothrombotic aorta on outcomes of total aortic arch replacement.
The effect of an atherothrombotic aorta on the short- and long-term outcomes of total aortic arch replacement, including postoperative neurologic deficits, remains unknown. We evaluated this relationship and also elucidated the synergistic effect of multiple other risk factors, in addition to an atherothrombotic aorta, on the neurologic outcome. ⋯ Patients with an atherothrombotic aorta and associated preoperative comorbidities might be predisposed to adverse short- and long-term outcomes, including transient neurologic deficits.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Efficacy of extracorporeal membrane oxygenation as a bridge to lung transplantation.
Preoperative extracorporeal membrane oxygenation (ECMO) is a risk factor for poor outcome and currently considered a contraindication to lung transplantation. The lung allocation score system was introduced in May 2005 and prioritizes lung allocation to those with the greatest respiratory impairment. The purpose of this study is to determine whether ECMO as a bridge to lung transplantation is an acceptable option to support those in respiratory failure until donor lungs become available in the lung allocation score era. ⋯ Although the incidence of primary graft dysfunction requiring post-transplant ECMO is higher and the hospital stay is longer in patients receiving pretransplant ECMO, the graft survival is good (2-year survival, 74%). ECMO is efficacious as a bridge to lung transplantation with good post-lung transplant outcomes.