Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jun 2009
Case ReportsThe Impella LP 5.0 as a bridge to long-term circulatory support.
Multi-organ failure (MOF) secondary to bi-ventricular cardiac dysfunction is a major therapeutic challenge. In addition to aggressive medical therapy, it frequently requires circulatory support with uni- or bi-ventricular assist devices. ⋯ We present a case of a patient in bi-ventricular failure successfully bridged to permanent circulatory support. Relative merits of this therapeutic approach are outlined and discussed.
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Interact Cardiovasc Thorac Surg · Jun 2009
Case ReportsAortic valve thrombosis after implantation of temporary left ventricular assist device.
The use of assist devices for ventricular support after myocardial infarction with cardiogenic shock has become common practice. Thrombosis, bleeding, and infection are common complications. However, native valve thrombosis is a rare complication. We present a case of aortic valve thrombosis after implantation of a left ventricular assist device (LVAD) treated with thrombus removal at time of device exchange.
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Interact Cardiovasc Thorac Surg · Jun 2009
Comparative StudySelective antegrade cerebral perfusion at two different temperatures compared to hypothermic circulatory arrest--an experimental study in the pig with microdialysis.
Hypothermic arrest and selective antegrade cerebral perfusion (SACP) is widely used during aortic arch surgery. The microdialysis technique monitors biomarkers of cellular metabolism and cellular integrity over time. In this study, the cerebral changes during hypothermic circulatory arrest (HCA) at 20 degrees C and HCA with SACP at two different temperatures, 20 and 28 degrees C, were monitored. ⋯ The largest increase of glycerol was found in the group with tepid cerebral perfusion (28 degrees C) and the HCA group (P<0.05). This study supports the use of SACP over arrest. It also suggests that cerebral metabolism and cellular membrane integrity may be better preserved with SACP at 20 degrees C compared to 28 degrees C.
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Interact Cardiovasc Thorac Surg · Jun 2009
Case ReportsTension pneumocephalus complicating Pancoast tumor resection.
A case of tension pneumocephalus following Pancoast tumor resection is presented. Conservative management was successful. The presenting symptoms and signs, diagnostic methods and options for treatment are discussed and reviewed.