The heart surgery forum
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The heart surgery forum · Aug 2012
Case ReportsNear-infrared spectroscopy-detected cerebral ischemia resolved by cannulation of an axillo-femoral graft during surgical repair of type A aortic dissection.
We report the case of a patient who experienced near-infrared spectroscopy (NIRS)-detected transient regional cerebral desaturation during cardiopulmonary bypass for an operation to replace the aortic arch. Prompt institution of additional flow through an axillo-femoral graft was associated with restoration of regional cerebral saturation. The aortic surgery had no neurologic complications. Promptness in detecting and restoring cerebral perfusion appeared crucial in avoiding prolonged cerebral ischemia and reducing the likelihood of adverse neurologic events.
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The heart surgery forum · Aug 2012
Case ReportsOne hundred ten days of extracorporeal membrane oxygenation in a young woman with postpartum cerebral venous thrombosis and acute respiratory distress syndrome.
Extracorporeal membrane oxygenation (ECMO) is often the last resort for serious acute respiratory distress syndrome (ARDS) when all non-invasive treatment options have failed to improve the patient's pulmonary condition. We present a successful long-term therapy with ECMO over 110 days in a 28-year-old woman. She developed postpartum cerebral venous thrombosis with severe respiratory insufficiency. Veno-venous ECMO rescued this young patient, allowing for full recovery.
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The heart surgery forum · Aug 2012
Simple technique to verify CO(2) diffusion with the CarbonAid™ device.
It has become common practice in cardiac surgery to flood the operative field with CO(2) to facilitate deairing of the heart. However, CO(2) delivery is variable and verification of CO(2) delivery can be challenging. We report a simple, reliable method to confirm CO(2) delivery. This technique ensures that the benefits of CO(2) delivery are provided to the patient during the operation.
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The heart surgery forum · Aug 2012
Can we identify risk factors for postoperative delirium in cardiac coronary patients? Our experience.
Delirium is a temporary mental disorder that frequently occurs among elderly hospitalized patients. Patients who undergo cardiac operations have an increased risk of postoperative delirium, which is associated with higher mortality and morbidity rates, a prolonged hospital stay, and reduced cognitive and functional recovery. ⋯ Three of the four predictive factors significantly associated with delirium are preoperative. They are relatively easy to measure and can be used to identify patients at higher risk. Fast extubation of these patients and preventive interventions can be taken to prevent negative consequences of this postoperative complication.
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The heart surgery forum · Jun 2012
Ten-year outcome analysis of off-pump sequential grafting: single surgeon, single center experience.
Despite increasing recognition that off-pump coronary artery bypass surgery and sequential grafting strategy individually are associated with improved outcomes, concerns persist regarding the safety and efficacy of combining these 2 techniques. We compared in-hospital and midterm outcomes for off-pump multivessel sequential and conventional coronary artery bypass grafting. ⋯ Our analysis confirms the short- and midterm safety and efficacy of off-pump sequential coronary artery bypass grafting.