Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2014
Randomized Controlled Trial Comparative Study Observational StudyInterposed abdominal compression-cardiopulmonary resuscitation after cardiac surgery.
The management of cardiac arrest after cardiac surgery differs from the management of cardiac arrest under other circumstances. In other studies, interposed abdominal compression-cardiopulmonary resuscitation (IAC-CPR) resulted in a better outcome compared with conventional CPR. The aim of the present study was to determine the feasibility, safety and efficacy of IAC-CPR compared with conventional CPR in patients with cardiac arrest after cardiac surgery. ⋯ IAC-CPR is feasible and safe and may be advantageous in cases of cardiac arrest after cardiac surgery.
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Interact Cardiovasc Thorac Surg · Dec 2014
ReviewEfficacy and safety of negative pressure wound therapy for Szilagyi grade III peripheral vascular graft infection.
A best evidence topic in vascular surgery was written according to a structured protocol. The question addressed was whether it is safe and effective to use negative pressure wound therapy (NPWT) for Szilagyi grade III (i.e. the arterial implant proper involved in the infection) peripheral vascular graft infection. Altogether, 69 papers were found using the reported search. ⋯ The major complication of NPWT was bleeding and the incidence rate was reported to be <10%. We conclude that the amount of evidence for recommending NPWT alone as the first-line treatment for Szilagyi grade III peripheral vascular graft infection is small with only one small-sized randomized controlled trial demonstrating that NPWT alone is superior to alginate dressing change in shortening the time to complete wound healing by 2 months. Limited evidence (case series with >1 year of follow-up) showed that NPWT with a continuous negative pressure of 125 mmHg, or combined NPWT and sartorius myoplasty, may shorten the time to complete wound healing by 2 months, have a >70% success rate, and have a <10% NPWT-related complication rate.
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Interact Cardiovasc Thorac Surg · Dec 2014
Case ReportsOver 1200-day support with dual Jarvik 2000 biventricular assist device.
We report the successful longest biventricular support using dual Jarvik 2000 biventricular assist device (BVAD; Jarvik Heart, Inc., New York, NY, USA) as a bridge to transplant. A 27-year old woman with arrhythmogenic right ventricular cardiomyopathy underwent implantation of two Jarvik 2000s as a left ventricular assist device and right ventricular assist device. ⋯ Despite advances in continuous-flow ventricular assist devices, their long-term use for biventricular support remains limited. We report a successful case of 1245 days of biventricular support with dual Jarvik 2000 axial flow pumps in a patient with a small body surface area.
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Interact Cardiovasc Thorac Surg · Dec 2014
Observational StudyTriple valve surgery in the modern era: short- and long-term results from a single centre.
Triple valve surgery (TVS) is still a challenge for surgeons because of prolonged cardiopulmonary bypass (CPB) and myocardial ischaemic times. The reported operative mortality rate for TVS ranges between 2.5 and 25%; long-term survival is also diminished, with reported survival rates at 5 and 10 years of 75-82 and 61-75%, respectively. The objective of our study is to define early and late clinical outcomes, reporting the initial experience in the treatment of triple valve disease through a minimally invasive approach. ⋯ TVS offers encouraging short-term and long-term patient survival; these good results after TVS in patients with advanced valvular heart disease justify aggressive surgical therapy in these patients. TVS with a minimally invasive approach is feasible and could be another treatment option.
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Interact Cardiovasc Thorac Surg · Dec 2014
Totally robotic atrial septal defect closure: 7-year single-institution experience and follow-up.
Robotic technology has been applied to atrial septal defect (ASD) repair for more than 10 years, but the number of cases reported is limited and results of long-term follow-up are not clear. This study reports on a large group of patients who underwent totally robotic ASD repair on an arrested or beating heart at a single institution with a 7-year follow-up. ⋯ ASD can be performed safely and effectively on an arrested or beating heart with the assistance of robotic technology. This totally endoscopic approach represents an option for patients seeking a reliable, minimally invasive ASD repair with an excellent long-term result.