Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2007
Clinical TrialDoes poor oxygenation during one-lung ventilation impair aerobic myocardial metabolism in patients with symptomatic coronary artery disease?
One-lung ventilation is used during a variety of surgical procedures, even in patients with pre-existing coronary artery disease. The study purpose was to elucidate if myocardial metabolism crosses the anaerobic threshold under hypoxemia during one-lung ventilation. Therefore, we determined myocardial metabolism as a marker for anaerobic myocardial metabolism in patients with significant multi-vessel coronary artery disease undergoing one-lung ventilation during minimally-invasive coronary artery bypass grafting. ⋯ No clinically significant signs of myocardial ischemia occurred in any patient. Aerobic myocardial metabolism was unaffected during one-lung ventilation in all patients. Therefore, one-lung ventilation can be applied to patients with multi-vessel coronary artery disease with an acceptable risk of turning myocardial metabolism to an anaerobic state.
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Interact Cardiovasc Thorac Surg · Apr 2007
Case ReportsCardiac tamponade: an unusual, lifethreatening complication after transhiatal resection of the esophagus.
Transhiatal resection for carcinoma of the distal esophagus is associated with relative high morbidity and mortality. We present a rare case of cardiac tamponade after transhiatal esophagectomy for which emergency sternotomy was performed. Probably the retraction of the heart during exploration of the mediastinum caused a laceration of an epicardial vein. Although very rare, cardiac tamponade should be considered when hemodynamic instability during or after transhiatal esophagectomy occurs.
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Interact Cardiovasc Thorac Surg · Apr 2007
Comparative StudyProcalcitonin and brain natriuretic peptide as parameters in the postoperative course of patients with major pulmonary resection.
Postoperative infections and cardiac events are the major morbidity factors after thoracic surgery and dominating causes of death. Therefore, a sensitive blood marker is needed for an early diagnosis of complications. Twenty-two patients admitted with lung cancer were enrolled in this study. ⋯ In general, brain natriuretic peptide and procalcitonin levels are increased in the postoperative course after major pulmonary resection, but cardiac and infectious complications are associated with higher levels and a slower decrease than without complications. Interleukin-6 levels showed a slower decrease in patients with complications in the postoperative course than without complications. So the combination of procalcitonin, brain natriuretic peptide, and interleukin-6 seems to be useful for an optimized postoperative monitoring.
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Interact Cardiovasc Thorac Surg · Apr 2007
Comparative StudyComparison of distensibility of the aortic root and cusp motion after aortic root replacement with two reimplantation techniques: Valsalva graft versus tube graft.
The aim of this study is to evaluate distensibility of the aortic root and function of the aortic cusp after aortic root replacement using valve sparing procedure. Between October 1999 and August 2006, valve sparing aortic root replacements were performed in 39 patients who had annuloaortic ectasia (AAE) and aortic valve regurgitation. Reimplantation type of valve-sparing procedure was performed with a tube graft (n=12) or a Valsalva graft (n=27). ⋯ RVOV/HR in Group T was highest among the three groups (T: 48.2+/-6.2, V: 36.2+/-11.9, C: 33.7+/-9.6). RVCV/HR showed no difference among the three groups (T: 26.1+/-6.7, V: 40.7+/-16.6, C: 28.4+/-16.3). In conclusion, sinus distensibility of the Valsalva graft was well preserved and valve-opening characteristics with the Valsalva graft were identical to normal.
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Interact Cardiovasc Thorac Surg · Apr 2007
Case ReportsPositron emission tomography staging of pleural deposits following Monaldi's procedure: an accurate reflection or a false staging?
Positron emission tomography (PET) has become widely available in staging non-small cell lung cancer (NSCLC) and despite its high accuracy, false positive staging remains a problem. We report a rare case where such false positive staging caused a dilemma in optimal management.