Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2008
ReviewIs blood cardioplegia superior to crystalloid cardioplegia?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether blood cardioplegia is clinically superior to crystalloid cardioplegia for myocardial protection. Altogether 501 papers were identified. ⋯ Of these, 10 reported some statistically significant clinical outcomes in favour of blood cardioplegia and five reported statistically significant differences in enzyme release in favour of blood cardioplegia. A recent survey of UK practice found that 56% of surgeons use cold blood cardioplegia, 14% use warm blood cardioplegia, 14% use crystalloid cardioplegia, 21% use retrograde infusion and 16% do not use any cardioplegia. The papers presented in our review support most of these practices!
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Interact Cardiovasc Thorac Surg · May 2008
Case ReportsSurgical repair of post-traumatic lung hernia using a video-assisted open technique.
Post-traumatic lung herniation through a defect in the chest wall is an uncommon injury, with only about 300 reported in the literature. Various methods of treatment and repair have been described, including both purely thoracoscopic to full open techniques. We repaired a case by using a combination of minithoracotomy and video-assistance through the minithoracotomy wound. The patient did well and there was minimal postoperative pain.
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Interact Cardiovasc Thorac Surg · May 2008
Comparative StudyBiochemical markers of myocardial injury in the pericardial fluid of patients undergoing heart surgery.
The purpose of this study was to compare cardiac markers in the pericardial fluid and serum in order to evaluate preoperative myocardial injury. Thirty patients were divided into three groups. The first group (AVR; n=10) received an aortic valve replacement. ⋯ Preoperative pericardial and serum cTnI were significantly higher in the ACS than in AVR and SA groups (P<0.01). Postoperative pericardial concentration of all markers was significantly higher (P<0.01) than in serum in all groups. We conclude that preoperative pericardial accumulation of cTnI may reflect subclinical injury which may not be demonstrated by the usual laboratory tests.
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Interact Cardiovasc Thorac Surg · May 2008
Case ReportsThe use of intra-aortic balloon pump as cerebral protection in a patient with moyamoya disease undergoing coronary artery bypass grafting.
We performed coronary artery bypass grafting in an urgent and rare case of acute coronary syndrome with moyamoya disease in a 75-year-old female. Because of collateral dependent severe cerebrovascular obstruction, additional support for brain protection was necessary; we used high pressure pulsatile perfusion assist to maintain cerebral circulation with an intra-aortic balloon pump support throughout the cardiopulmonary bypass, giving a successful outcome.