The Annals of thoracic surgery
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Comparative Study
Preoperative two- and three-dimensional transesophageal echocardiographic assessment of heart tumors.
Two-dimensional transesophageal echocardiography is the most widely used diagnostic approach in the rare entity of heart tumors. The aim of this study was to assess the diagnostic usefulness of three-dimensional echocardiography in comparison with the two-dimensional technique in a rare clinical setting. ⋯ Three-dimensional transesophageal echocardiography yields important additional clinical information and improves the operative planning. Three-dimensional echocardiography may become the best approach to study the anatomy and pathology of the heart as it provides an objective display of cardiac size and shape in heart tumors.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tranexamic acid reduces postbypass blood use: a double-blinded, prospective, randomized study of 210 patients.
Pharmacologic intervention to minimize postbypass bleeding and blood product transfusions has received increasing attention for both medical and economic reasons. ⋯ Tranexamic acid is safe and effective in reducing blood loss and blood use in a wide variety of cardiac surgical patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Autotransfusion after coronary artery bypass grafting halves the number of patients needing blood transfusion.
Several randomized studies about autotransfusion of shed mediastinal blood in patients undergoing coronary artery bypass grafting have resulted in divergent findings concerning reduction of the need for homologous blood transfusions. Most of these studies used less strict criteria for homologous blood transfusion than applied in daily clinical practice. ⋯ Autotransfusion of shed mediastinal blood in patients undergoing elective, uncomplicated coronary artery bypass grafting halves the number of patients needing homologous blood and reduces the amount of homologous blood given.
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Randomized Controlled Trial Comparative Study Clinical Trial
Aprotinin modulation of platelet activation in patients undergoing cardiopulmonary bypass operations.
Aprotinin significantly decreases postoperative blood loss, yet its exact mechanism of action remains unproven. ⋯ This study demonstrates that in the presence of aprotinin, platelets remain unstimulated during CPB and the von Willebrand GPIb-mediated activatability of platelets is preserved, thus maintaining a viable platelet population. Most important, this study reveals that these mechanisms are more related to platelet-leukocyte than to platelet-platelet interactions.