Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2011
Randomized Controlled Trial Comparative StudyMini-cardiopulmonary bypass impact on blood conservation strategy in coronary artery bypass grafting.
Cardiopulmonary bypass (CPB) using a closed circuit system with minimal priming volume can be a solution to ameliorate adverse effects of CPB. We hypothesize that the use of mini-bypass in routine coronary artery bypass grafting (CABG) reduces homologous blood product use and postoperative bleeding. The study is designed to determine the differences in blood loss and transfusion requirements associated with a minimized CPB circuit vs. a standard bypass circuit. ⋯ The adoption of mini-bypass significantly reduces morbidity including donor blood usage and postoperative bleeding in routine CABG patients.
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Interact Cardiovasc Thorac Surg · Apr 2011
Case ReportsLate presentation of foreign body aspiration requiring extracorporeal membrane oxygenation support for surgical management.
We present the case of a near fatal aspiration of a foreign body requiring extracorporeal membrane oxygenation (ECMO) support. The use of ECMO to support treatment for a foreign body in the distal trachea is rare and there are only two cases reported in the literature. A 13-year-old male presented with a three-weeks' history of a cough and swinging fevers. ⋯ This is the first reported use of ECMO support for an acute presentation of a chronic problem. If the patient is too unstable for bronchoscopy, ECMO can be used to temporarily stabilise the patient allowing safe removal of the object. If the patient is acutely unwell and septic, ECMO should be more readily considered.
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Interact Cardiovasc Thorac Surg · Apr 2011
Comparative StudyLong-term morbidity and quality of life after surgical repair of transposition of the great arteries: atrial versus arterial switch operation.
Since a growing number of patients after surgical repair of transposition of the great arteries (TGA) survive until adulthood the focus of attention has shifted to the management of associated long-term morbidity and quality of life (QoL). Therefore, we reviewed all patients that underwent surgical repair of TGA at our institution and compared long-term results after atrial and arterial switch operation. Between 1973 and 2000, a total of 302 patients underwent either atrial switch operation (n=222) or arterial switch operation (n=80). ⋯ There was a trend towards a more favourable outcome of the arterial switch group concerning freedom from re-interventions, severe systemic ventricular dysfunction and need for heart failure medication. However, also the arterial switch operation was associated with an increased incidence of loss of sinus rhythm and neo-aortic valve regurgitation during late follow-up. Health related QoL according to the SF-36 questionnaire was not significantly different between both groups and comparable to a healthy population.