The heart surgery forum
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The heart surgery forum · Dec 2014
Clinical TrialPericardiectomy: prompt surgical management of constrictive pericarditis.
Constrictive pericarditis is a slow progressive fibrosis of the pericardium leading to a variety of symptoms and signs over time. The disease poses a diagnostic challenge; restrictive cardiomyopathy and other syndromes associated with right-sided pressure abnormalities share similar symptoms and clinical findings. Pericardiectomy is considered the treatment of choice for constrictive pericarditis. Here we studied the effects of total radical pericardiectomy on hemodynamics in 37 patients diagnosed with constrictive pericarditis. ⋯ Radical pericardiectomy is a demonstrably useful procedure for correction of hemodynamic abnormalities and improvement of overall heart function in symptomatic patients with constrictive pericarditis.
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The heart surgery forum · Dec 2014
Relationship between nadir hematocrit during cardiopulmonary bypass and postoperative hyperglycemia in nondiabetic patients.
Hyperglycemia is common after cardiac surgery in both diabetic and nondiabetic patients and is associated with increased morbidity and mortality. Association between nadir hematocrit levels on cardiopulmonary bypass (CPB) and postoperative hyperglycemia is not clear. This study was carried out to determine the relationship between nadir hematocrit during CPB and postoperative hyperglycemia in nondiabetic patients. ⋯ Nadir hematocrit levels on CPB less than 20% and allogenic blood transfusions were independently associated with postoperative hyperglycemia in nondiabetic patients. Patients with a nadir hematocrit levels less than 20 % during CPB should be closely monitored for hyperglycemia in the perioperative period.
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The heart surgery forum · Oct 2014
Case ReportsA case of Heyde syndrome: resolution following aortic valve replacement.
Heyde syndrome is a triad of aortic stenosis, acquired coagulopathy, and anemia due to bleeding from intestinal angiodysplasia. Here we describe a case of this syndrome. An 80-year-old woman with severe aortic stenosis was referred to our department for an aortic valve replacement. ⋯ She was discharged on postoperative day 22. No transfusions were needed after the procedure. To date, her hemoglobin has remained stable at >10 mg/dL.
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The heart surgery forum · Oct 2014
Case ReportsImproved angiographic findings of superficial femoral artery after verapamil injection into the reperfusion cannula of a patient on peripheral venoarterial ECMO.
Limb ischemia is a complication that can occur in patients requiring percutaneously placed venoarterial extracorporeal membrane oxygenation (ECMO). One method used to prevent limb ischemia is the placement of an antegrade catheter into the superficial femoral artery. We describe a case is which the angiographic findings of the superficial femoral artery were improved by the injection of verapamil in a patient with limb ischemia.
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The heart surgery forum · Oct 2014
Randomized Controlled TrialThe effect of lidocaine and amiodarone on prevention of ventricular fibrillation in patients undergoing coronary artery bypass grafting.
Ventricular fibrillation is common after aortic declamping in patients undergoing open heart surgery. This situation has a negative impact on morbidity and mortality. The aim of this prospective study was to compare the effect of administering lidocaine versus amiodarone before aortic declamping during elective coronary bypass grafting, paying close attention to when the initial effect of amiodarone sets in. ⋯ We suggest that during coronary arterial bypass surgery, administration of an amiodarone regime before release of the aortic cross clamp, paying particular attention to the start of the initial effect of amiodarone, is no more effective than lidocaine for prevention from arrhythmia; however, amiodarone reduces the need for electrical defibrillation.