Heart, lung & circulation
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Heart, lung & circulation · May 2014
Clinical TrialPre-hospital ambulance notification and initiation of treatment of ST elevation myocardial infarction is associated with significant reduction in door-to-balloon time for primary PCI.
Mortality in ST elevation myocardial infarction (STEMI) is strongly predicted by the time from first medical contact to reperfusion. The aim of this study was to examine the impact of pre-hospital diagnosis by paramedics in the field on the door-to-balloon (DTB) times of patients with ST elevation myocardial infarction undergoing primary percutaneous intervention. ⋯ Pre-hospital intervention at our centre had a powerful effect in reducing the time to reperfusion in patients with STEMI undergoing primary percutaneous intervention.
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Heart, lung & circulation · May 2014
Single-centre experience with perioperative use of intraaortic balloon pump in cardiac surgery.
Intraaortic balloon pump (IABP) is frequently used in cardiac surgery in order to prevent or treat low cardiac output syndrome. Although being widely used and forming the first line therapy in these haemodynamically unstable patients despite maximal medication, optimal timing for IABP insertion is still discussed. This retrospective study evaluates hospital outcomes of patients receiving IABP at preoperative, intraoperative and postoperative periods during cardiac surgery. ⋯ IABP insertion timing in cardiac surgery is crucial and many reports advocate early insertion since patient outcomes are poor for late insertions. This single centre study also confirms that the least favourable results are among patients with postoperative IABP insertion.
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Heart, lung & circulation · May 2014
Cost-effectiveness of interventions to prevent cardiovascular disease in Australia's indigenous population.
Cardiovascular disease is the leading cause of disease burden in Australia's Indigenous population, and the greatest contributor to the Indigenous 'health gap'. Economic evidence can help identify interventions that efficiently address this discrepancy. ⋯ Local and decision-making contextual factors are important in the conduct and interpretation of economic evaluations. For Australia's Indigenous population, different models of health service provision impact on reach and cost-effectiveness results. Both the extent of health gain and cost-effectiveness are important considerations for policy-makers in light of government objectives to address health inequities and bridge the health gap.
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Heart, lung & circulation · Apr 2014
Prevention of retrosternal pericardial adhesions after cardiac surgery with mitomycin C.
Retrosternal pericardial adhesions may cause significant injuries to the heart and great vessels in cases that require reoperation. Fibroblast proliferation is one of the mechanisms for adhesion formation. Inhibition of fibroblast proliferation is important in reduction of retrosternal adhesions. Mitomycin C (MMC) is able to reduce fibroblast proliferation. We aimed to determine the effect of MMC on prevention of retrosternal pericardial adhesions after primary cardiac operations. ⋯ MMC was found to be effective in the prevention of retrosternal pericardial adhesions without any delay in normal tissue regeneration.