Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Aug 2017
Multicenter Study Observational StudyRe-exploration due to bleeding is not associated with severe postoperative complications.
In cardiac surgery, postoperative bleeding remains a frequent complication with various possible adverse outcomes. Re-exploration due to bleeding is frequent in this type of patient. Sternal wound infection is an infrequent but serious and devastating complication. Whether re-exploration due to bleeding significantly affects the incidence of sternal wound infection is uncertain. There is no consensus on allowed severity of bleeding and timing of intervention. ⋯ Our study indicates that re-exploration is not associated with a higher frequency of severe postoperative complications. Probably the time of intervention for bleeding is important.
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Interact Cardiovasc Thorac Surg · Aug 2017
Ventricular assist device support in patients with single ventricles: the Melbourne experience.
The capacity and limitations of ventricular assist device (VAD) support in single-ventricle physiology remains poorly understood. We aimed to review our experience in the use of VAD support in the single-ventricle circulation to determine its feasibility in this population. ⋯ VAD support in patients with a single ventricle has a high hospital mortality, with 1 of 3 patients surviving to discharge. Systemic VAD support is likely futile in the setting of early Fontan failure or when re-initiation of support is required.
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Interact Cardiovasc Thorac Surg · Aug 2017
Vasoplegia after heart transplantation: outcomes at 1 year.
Vasoplegia syndrome is a potentially life-threatening condition that can occur following cardiopulmonary bypass. Heart transplantation is a recognized risk factor for developing this vasodilatory state. The objective of this study was to determine the effects of vasoplegia syndrome on 1-year heart transplant outcomes. ⋯ Although vasoplegia syndrome was associated with an increase in perioperative morbidity, including greater mechanical ventilation time and hospital length of stay, no significant differences in survival or allograft rejection at 1 year was demonstrated.
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Interact Cardiovasc Thorac Surg · Jul 2017
Case ReportsSevere aortic regurgitation after implantation of a sutureless valve prosthesis using an automatic knot fastener device.
We report the case of severe aortic regurgitation 8 months after implantation of a 25-mm sutureless pericardial aortic valve prosthesis. On echocardiography, the regurgitation was suspected to be paravalvular. The sutureless prosthesis had been implanted using an automatic knot fastener device, which renders the suture tails less pliable because of the metal clip that is crimped around the suture. ⋯ The leaflet perforation was in alignment with one of the knots produced by the automatic knot fastener. Obviously, the leaflet had hit the knot repeatedly which had caused the perforation. We conclude that knots produced by an automatic fastener device have the potential to cause leaflet perforation.
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Interact Cardiovasc Thorac Surg · Jul 2017
Observational StudyTransapical transcatheter mitral valve-in-valve implantation versus minimally invasive surgery for failed mitral bioprostheses.
The aim of this study was to compare early outcomes and survival of patients undergoing minimally invasive mitral valve replacement through a right anterior minithoracotomy (MIMVR) versus patients undergoing transcatheter transapical mitral valve-in-valve (M-VIV) implantation for a failed mitral bioprostheses. ⋯ In selected patients, M-VIV can be performed safely with results comparable with those of surgical therapy.