Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2008
Propranolol: a new indication for an old drug in preventing postoperative junctional ectopic tachycardia after surgical repair of tetralogy of Fallot.
Junctional ectopic tachycardia (JET) is a major cause of postoperative morbidity after complete repair of tetralogy of Fallot (TOF). Propranolol is a known medication used in patients with TOF to prevent and control hypercyanotic spells. Despite this, there is little information regarding the relation between preoperative use of propranolol and the incidence of postoperative JET. ⋯ The propranolol group had significantly less mechanical ventilation time, less ICU stay and less total hospital stay than the control group (P<0.05). Our findings suggest that the preoperative use of propranolol may decrease the incidence of JET after full surgical repair of TOF. A prospective randomized study may help to elucidate the exact relationship between the preoperative use of propranolol and the incidence of postoperative JET.
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Interact Cardiovasc Thorac Surg · Apr 2008
Clinical TrialDelayed recovery of human leukocyte antigen-DR expression after cardiac surgery with early non-lethal postoperative complications: only an epiphenomenon?
HLA-DR expression on peripheral blood monocytes is reduced after cardiac surgery. Little is known about the reconstitution of HLA-DR expression on peripheral blood monocytes in patients suffering from early non-fatal perioperative complications. We conducted a prospective study to prove whether these complications adversely affect the recovery of HLA-DR expression. ⋯ A delayed recovery of HLA-DR expression is seen in patients with early perioperative complications. These non-fatal complications appear to represent a 'second hit' resulting in a prolonged deficiency of the innate immune system. This might predispose to further infectious and septic complications.
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Interact Cardiovasc Thorac Surg · Apr 2008
Case ReportsTotal cavo-pulmonary connection without foreign material for asplenic heart associated with partial anomalous pulmonary venous connection.
The presented case was a 3-year-old boy diagnosed with asplenia (SLL), double outlet right ventricle, pulmonary stenosis, atrioventricular septal defect, hypoplastic left ventricle and partial anomalous pulmonary venous connection to the superior vena cava. Partial anomalous pulmonary venous connection was repaired by translocation of pulmonary artery to avoid pulmonary venous obstruction when Glenn anastomosis was performed. Total cavo-pulmonary connection was established by re-routing the inferior vena cava to pulmonary artery using the atrial septal remnant and the left atrium free wall flap.
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Interact Cardiovasc Thorac Surg · Apr 2008
Case ReportsEntirely polytetrafluoroethylene coating for pacemaker system contact dermatitis.
A 63-year-old man underwent pacemaker implantation for complete atrio-ventricular block. The patient repeated admissions for skin necrosis, and generator or pacemaker system was re-implanted each time. The patient was admitted with skin necrosis of the generator pocket three years after re-implantation. ⋯ The patient underwent pacemaker system removal and re-implantation of polytetrafluoroethylene (PTFE) sheets coating pericardium leads and generator. There has been no recurrence. PTFE sheet coating is effective to treat pacemaker system contact dermatitis.
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Interact Cardiovasc Thorac Surg · Apr 2008
Percutaneous cardioplegia delivery using the miniport in minimally invasive mitral valve surgery.
Minimally invasive cardiac surgery involves limited exposure of cardiac structures. Extracorporeal circulation is usually conducted by peripheral cannulation. Cross-clamp can be achieved by remote ways of either balloon endoclamp or transthoracic clamp. ⋯ In order to prevent additional expenses, we sought to deliver cardioplegic solution in a simple, reproducible, and cost-effective way. The miniport is used for this application. The procedures are reported in detail.