The heart surgery forum
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The heart surgery forum · Dec 2011
Randomized Controlled TrialGlutamine is cardioprotective in patients with ischemic heart disease following cardiopulmonary bypass.
The aim of the present study was to investigate the cardioprotective effects of the perioperative use of N(2)-L-alanyl-L-glutamine (GLN) in patients with ischemic heart disease (IHD) who undergo their operations under cardiopulmonary bypass (CPB). ⋯ Perioperative administration of GLN during the first 24 hours has cardioprotective effects in IHD patients following CPB. This technique enhances the troponin concentration at 24 hours after surgery and is associated with improved myocardial function.
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The heart surgery forum · Dec 2011
A clinical and economic evaluation of fast-track recovery after cardiac surgery.
In the last 5 decades, the care of cardiac surgical patients has improved with the aid of strategies aimed at facilitating patient recovery. One of the innovations in this context is "fast-tracking" or "rapid recovery." This process refers to all interventions that aim to shorten a patient's stay in the intensive care unit (ICU) through accelerating the patient's transfer to a step-down or telemetry unit and to the general ward. ⋯ Fast-track recovery after cardiac surgery decreases the intensive care LOS and the total duration of intubation. It is a cost-effective strategy compared with conventional recovery protocols; however, it does not reduce the total hospital LOS or the incidence of complications.
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The heart surgery forum · Oct 2011
Left anterior descending artery revascularization in low-risk patients: early outcomes after off-pump versus on-pump surgery.
This study aimed to compare the early outcomes of off-pump and on-pump myocardial revascularization in patients with stenosis in the left anterior descending artery (alone or with diagonal artery disease). ⋯ Among low-risk patients (defined according to EuroSCORE criteria) who underwent left anterior descending coronary artery bypass, the results obtained with the on-pump and off-pump methods showed no significant differences with respect to morbidity or mortality.
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The heart surgery forum · Oct 2011
Case ReportsHigh-volume hemofiltration as adjuvant therapy for refractory shock after pericardiocentesis.
Pericardiocentesis for the treatment of chronic cardiac tamponade can occasionally result in acute pulmonary edema or biventricular failure. A sudden increase in heart filling pressures and right-to-left ventricular-output mismatch have been proposed underlying mechanisms. ⋯ We conclude that high-volume hemofiltration can be helpful as an adjuvant treatment for refractory shock after pericardiocentesis for chronic cardiac tamponade. The mechanism of the observed hemodynamic improvement remains to be investigated.
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The heart surgery forum · Aug 2011
Case ReportsRadical and harmless shave resection of atypical papillary fibroelastomas of the cardiac valves.
Papillary fibroelastomas (PFEs) are rare cardiac tumors usually treated by shave resection. Up to 20% of the patients are actually denied such a conservative surgical approach because atypical morphology is thought to preclude radical and effective outcomes. ⋯ In experienced hands surgical shave resection is the gold standard for the treatment of PFE even in atypical presentations.