The heart surgery forum
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The heart surgery forum · Aug 2010
Case ReportsDealing with a septal hematoma after switch operation with ventricular septal defect closure.
We report the case of a 7-day-old boy who underwent operation for transposition of the great arteries with a ventricular septal defect. An intraseptal hematoma occurred postoperatively. ⋯ We opted for a conservative approach. In the "Discussion," we elaborate on the existing literature.
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The heart surgery forum · Aug 2010
Tranexamic Acid in cardiac surgery and postoperative seizures: a case report series.
With the recent withdrawal of the antifibrinolytic aprotinin from the market, tranexamic acid (TxA) has become more widely used. This change has led to increasing concern about the side-effect profile of TxA, particularly the incidence of postoperative seizures. In this case series, we describe 7 patients over an 18-month period who had open-chamber cardiac surgery and developed seizures in the postoperative period. ⋯ The exact mechanism of TxA-induced seizures is thought to be via inhibition of gamma-aminobutyric acid receptors in neurons. Data from the neurosurgical literature show a well-established link between this antifibrinolytic and seizures. There is now increasing awareness of this association in cardiac surgery, particularly when high TxA doses are used.
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The heart surgery forum · Jun 2010
Efficiency of preoperative tranexamic Acid in coronary bypass surgery: an analysis correlated with preoperative clopidogrel use.
This study evaluates the efficiency of prophylactic tranexamic acid in coronary bypass surgery with respect to preoperative clopidogrel use. ⋯ Prophylactic tranexamic acid reduces bleeding and the need for transfusion. This effect exists in patients using clopidogrel but is less prominent. Preoperative use may be beneficial in patients using clopidogrel without any need for delaying the surgical procedure.
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The heart surgery forum · Jun 2010
Totally endoscopic robotic atrial septal defect repair on the beating heart.
Atrial septal defect (ASD) repairs have successfully been performed on the arrested heart with the da Vinci S Surgical System (Intuitive Surgical). This study assessed the feasibility, safety, and efficacy of the use of the da Vinci S Surgical System for on-pump ASD repairs on the beating heart without cross-clamping the aorta. ⋯ We have shown that use of the da Vinci S Surgical System to perform on-pump ASD repairs on the beating heart without cross-clamping the aorta is feasible, safe, and effective.
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The heart surgery forum · Jun 2010
Case ReportsCoronary artery fistula detected by 64-slice multidetector computed tomography: case report.
Coronary artery fistula (CAF), a rare anomaly of a coronary artery, is defined as an anomalous communication between a coronary artery and a cardiac chamber or vessels. Coronary angiography remains the main modality for diagnosing CAF. We present a case of fistulous communication between the left anterior descending coronary artery and the main pulmonary artery. ⋯ Surgical ligation on a beating heart was carried out. Intraoperative Doppler flow detection was used to evaluate the shunt of the CAF. We prefer MDCT as a new diagnostic modality to provide the detailed anatomy of a CAF.