Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2013
Multicenter StudyFeasibility and safety of minimized cardiopulmonary bypass in major aortic surgery.
Conventional cardiopulmonary bypass causes haemodilution and is a trigger of systemic inflammatory reactions, coagulopathy and organ failure. Miniaturized cardiopulmonary bypass has been proposed as a way to reduce these deleterious effects of conventional cardiopulmonary bypass and to promote a more physiological state. The use of miniaturized cardiopulmonary bypass has been reported in low-risk patients undergoing valve and coronary artery bypass graft (CABG) surgery. However, little is known about its application in major aortic surgery. ⋯ Our experience suggests that miniaturized cardiopulmonary bypass is safe and feasible for use in major aortic cardiac surgery. A randomized trial is needed to evaluate miniaturized cardiopulmonary bypass formally.
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Interact Cardiovasc Thorac Surg · Oct 2013
Association of perioperative troponin and atrial fibrillation after coronary artery bypass grafting.
Prediction of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) may lead to preventive or early treatment and improved outcome. We investigated the association of serial perioperative cardiac troponin T (cTNT) measurements with postoperative AF in patients undergoing CABG. ⋯ Perioperative cTNT is univariably associated with postoperative AF after CABG, but not independently. Further, no clinically useful cut-off point for preventive or early treatment could be identified. Both perioperative cTNT and postoperative AF are associated with negative outcome and prolonged hospital stay.
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Interact Cardiovasc Thorac Surg · Oct 2013
Down syndrome and postoperative complications after paediatric cardiac surgery: a propensity-matched analysis.
The incidence of congenital heart disease is ~50%, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery. ⋯ After propensity matching Down syndrome was not associated with increased mortality or complication rate following congenital cardiac surgery.
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Interact Cardiovasc Thorac Surg · Oct 2013
Case ReportsTranscatheter valve used in a bailout technique during complicated open mitral valve surgery.
Here, we describe the case of a 62-year old woman who required aortic and mitral valve replacement plus coronary artery bypass grafting. Transoesophageal echocardiogram revealed stenosis of the aortic valve (Ao valve area, 0.9 cm(2); PG, 45 mmHg; MG, 25 mmHg) and a diseased calcified mitral valve with stenosis and regurgitation (mitral valve area, 1.1 cm(2); MG, 10 mmHg; RV, 25 ml; ERO, 12 mm(2)). The mitral annulus calcifications were very deep into the left atrium and the left ventricle muscle, around the full annulus circumference. ⋯ The left atrium was surgically exposed, and we deployed a 26-mm Edwards SAPIEN XT endovalve through the left atriotomy. To prevent paravalvular leakage, we then used a pericardial patch to close the gap between the endovalve and the calcified mitral annulus. The postoperative echocardiogram showed perfect anchoring of the endovalve in the mitral annulus without any paravalvular leakage.