Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2013
Randomized Controlled Trial Comparative StudyEffectiveness of biatrial pacing in reducing early postoperative atrial fibrillation after the maze procedure.
Interatrial conduction abnormalities have an important role in the initiation of recurrent atrial fibrillation (AF) after the maze procedure. Biatrial pacing or single atrial pacing alters the site and timing of atrial depolarization and may improve restoration of sinus rhythm after the maze procedure. To further evaluate whether biatrial pacing is superior to single atrial or no pacing, we performed a randomized prospective study on 240 patients with a full maze procedure to compare the effectiveness with different pacing approaches in the postoperative period. ⋯ Biatrial overdrive pacing is well tolerated and more effective in preventing the early recurrence of atrial fibrillation after the maze procedure. The impacts of the long-term results with the maze procedure require further study.
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Interact Cardiovasc Thorac Surg · May 2013
Comparative StudyHaemostasis alterations in coronary artery bypass grafting: comparison between the off-pump technique and a closed coated cardiopulmonary bypass system.
To compare coagulation and fibrinolysis activation in off-pump coronary artery bypass operation and in patients in whom a closed phosphorylcholine-coated cardiopulmonary bypass system was applied. Cardiopulmonary bypass induces activation of coagulative and fibrinolytic systems, which together with intraoperative haemodilution augment the risk of postoperative bleeding and transfusion of blood products. ⋯ The Physio cardiopulmonary bypass approach does not significantly alter haemostasis during the operation compared with off-pump coronary artery bypass providing a reduced activation in the postoperative period reducing also chest tube drainage. However, further priming volume reduction is required to decrease intraoperative red blood cell transfusion.
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Interact Cardiovasc Thorac Surg · May 2013
Comparative StudyCavopulmonary anastomosis without cardiopulmonary bypass.
There is an increasing trend to perform the bidirectional superior cavopulmonary (Glenn) anastomosis without cardiopulmonary bypass. In this report, we present our results of off-pump bidirectional Glenn operation done without using a venoatrial shunt to decompress the superior vena cava during clamping. [corrected]. ⋯ Off-pump bidirectional Glenn operation without caval decompression is a safe, simple and more economic procedure.
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Interact Cardiovasc Thorac Surg · May 2013
Case ReportsHybrid treatment of a dislocated atrial septal occluder device at the bifurcation of the left and right common iliac artery.
Percutaneous closure of secundum atrial septal defects (ASDs) with atrial septal occluders (ASOs) avoids sternotomy and cardiopulmonary bypass, and thus is commonly preferred to open heart surgery. However, rare reports of dislocation of the ASO into the systemic circulation do exist. We report the use of an emergent hybrid procedure in the dislocation of an ASO at the bifurcation of the left and right common iliac artery. The dislocation was diagnosed 7 days after percutaneous closure of an ASD.
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Interact Cardiovasc Thorac Surg · May 2013
Wound complications after median sternotomy: a single-centre study.
Sternal wound complications following median sternotomy remain a challenge in cardiac surgery. Changes in both patient profile and type of operations have been observed in recent years. Therefore, we analysed current wound healing complications after median sternotomy at our centre. ⋯ Wound complications following median sternotomy remain a challenge to cardiac surgery. Redo and emergency operations are the most important risk factors in this contemporary series. More efforts seem mandatory to decrease this arduous morbidity and the costs of prolonged treatment.