The heart surgery forum
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The heart surgery forum · Jan 2007
ReviewTotally endoscopic coronary artery bypass grafting on the arrested heart.
In the late 1990s, totally endoscopic coronary artery bypass grafting was successfully introduced into the heart surgery armamentarium using robotic techniques. Surgeons have applied the da Vinci telemanipulation system in order to develop completely endoscopic placement of internal mammary artery bypass grafts, mainly to the left anterior descending artery system. ⋯ Another option is performing procedures on the beating heart using an endostablilizer and local coronary artery occlusion. In this review, the technique and specific aspects of the arrested heart version of totally endoscopic coronary artery bypass grafting are outlined.
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The heart surgery forum · Jan 2007
Randomized Controlled TrialPredictive significance of plasma levels of interleukin-6 and high-sensitivity C-reactive protein in atrial fibrillation after coronary artery bypass surgery.
Postoperative atrial fibrillation (AF) plays a major role in the determination of hemodynamic deterioration and can be associated with cardiovascular events after coronary artery surgery. Elevated interleukin (IL)-6 and C-reactive protein (CRP) levels in patients with AF suggest a role of inflammation in the pathogenesis of AF. We conducted a study to investigate the correlation between postoperative AF and IL-6 and high-sensitivity CRP (hsCRP). ⋯ Elevated IL-6 and hsCRP levels in patients with postoperative AF suggest inflammatory components have a role of in the pathogenesis of AF.
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The heart surgery forum · Jan 2007
Comparative StudyCardiac troponin T levels in on- and off-pump coronary artery bypass surgery.
Conventional coronary artery bypass graft surgery (CCAB) has been associated with greater myocardial injury than off-pump surgery (OPCAB). However, the extent of myocardial injury following CCAB and OPCAB has not been assessed by priority of surgery or the number of diseased vessels. We tested the hypothesis that the additional myocardial injury associated with CCAB compared with OPCAB is sustained when patients are stratified by priority and 2- or 3-vessel disease. ⋯ In summary, higher postoperative cTnT levels are associated with CCAB than with OPCAB, regardless of priority, number of diseased vessels, patient characteristics, or surgeon. OPCAB results in less myocardial injury in patients, whether they present with 2- or 3-vessel disease and whether they undergo urgent or elective cardiac surgery.
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The heart surgery forum · Jan 2007
Surgical challenges for urgent approach in penetrating heart injuries.
The aim of this clinical study is to assess the characteristics of penetrating heart injury and its surgical challenges for urgent surgical approach. ⋯ Although the most important factor affecting mortality in penetrating heart injuries is rapid transport, an urgent approach applied by a specialist team can decrease potential mortality and morbidity rates.
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The heart surgery forum · Jan 2007
Robotic totally endoscopic double-vessel bypass grafting: a further step toward closed-chest surgical treatment of multivessel coronary artery disease.
After the introduction of robotic technology into the heart surgery armamentarium the performance of totally endoscopic coronary artery bypass grafting (TECAB) has become a reality. During the first years of development, the majority of TECAB cases were restricted to single-vessel disease, and the development of multivessel procedures is desirable. We report on a preliminary series of totally endoscopic double-vessel coronary artery bypass grafting. ⋯ Totally endoscopic double-vessel coronary artery bypass grafting on the arrested heart is a reproducible procedure. This intervention offers maximal preservation of patient integrity, but the long operative times need to be investigated.