Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jul 2014
A need for speed? Bypass time and outcomes after isolated aortic valve replacement surgery.
To determine in the modern era if cardiopulmonary bypass (CPB) time has a significant effect on postoperative morbidity, mortality and long-term survival in patients undergoing isolated aortic valve replacement (AVR) surgery. ⋯ Despite improvements over time with regard to morbidity, mortality and long-term survival, CPB time remains a significant factor determining mediastinal blood loss, ICU and hospital length of stay, and in-hospital mortality.
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Interact Cardiovasc Thorac Surg · Jul 2014
Case ReportsSimultaneous cusp-sparing aortic root replacement and coarctectomy with total arch replacement from the midline incision.
Four cases of simultaneous surgery for aortic root aneurysm with aortic regurgitation and coarctation of the aorta were presented. Age at surgery ranged from 18 to 37 years and all were male. All had annuloaortic ectasia and dilatation of the ascending aorta, 3 had bicuspid aortic valve and 1 had acute localized aortic dissection. ⋯ Antegrade cerebral perfusion was used for brain protection. All patients survived and postoperative pressure difference between the upper and lower extremities disappeared. Postoperative aortogram was satisfactory.
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Interact Cardiovasc Thorac Surg · Jul 2014
Impact of vacuum-assisted closure therapy on outcomes of sternal wound dehiscence†.
Sternal wound dehiscence (SWD) after cardiac surgery is a rare but serious condition associated with considerable costs and morbidity. We sought to evaluate the results of the introduction of vacuum-assisted closure (VAC) therapy in the management of sternal wound dehiscence, compared with those of previous conventional treatments. ⋯ In our experience, the use of VAC therapy for the management of SWD was considerably effective in decreasing mortality (SWD related), incidence of complications and need for surgical procedures; thus, leading to a significant reduction of costs.
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Interact Cardiovasc Thorac Surg · Jul 2014
Comparative Study Observational StudyMitral valve repair versus replacement in patients with ischaemic mitral regurgitation and depressed ejection fraction: risk factors for early and mid-term mortality†.
Mitral valve (MV) surgery for ischaemic mitral regurgitation (IMR) in patients with depressed left ventricular ejection fraction (LVEF) is associated with poor outcomes. The optimal surgical strategy for IMR in these patients remains controversial. The objective of this study was to compare the early mortality and mid-term survival of MV repair versus MV replacement in patients with IMR and depressed LVEF undergoing coronary artery bypass grafting (CABG). ⋯ MV repair in CABG patients with IMR and depressed LVEF is not superior to MV replacement with regard to operative early mortality and mid-term survival.
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Interact Cardiovasc Thorac Surg · Jul 2014
Comparative StudyThe cost impact of short-term ventricular assist devices and extracorporeal life support systems therapies on the National Health Service in the UK.
The objective of the study was to assess the cost of using different blood pumps for short-term ventricular assist device (VAD) and extracorporeal life support (ECLS) systems for cardiac and cardiorespiratory failure in the UK. ⋯ CentriMag® and PediVAS® blood pumps can lead to significant cost savings to the National Health Service, when used instead of other pumps for short-term VAD or ECLS treatment.