The Annals of thoracic surgery
-
We investigated whether percutaneous cannulation of the coronary sinus could be accomplished without fluoroscopy using transesophageal echocardiography in patients undergoing minimally invasive cardiac operations. The coronary sinus was cannulated without significant complications using transesophageal echocardiography in 10 of 11 patients (mean, 10.5 minutes). Percutaneous cannulation of the coronary sinus can be accomplished in a safe and efficient manner using transesophageal echocardiography without the need for fluoroscopy.
-
To determine the differences in clinical behavior of bovine versus autologous pericardium, all consecutive patients undergoing aortic valve reconstruction were reviewed. ⋯ Aortic valve reconstruction with pericardium can be safely performed with low thromboembolic rate. At 8 years follow up, there is a difference in favor of the autologous pericardium.
-
Neurologic complications, primarily resulting from ischemic insults, represent the leading cause of morbidity and disability, and the second most common source of death, after cardiac operations. Previous studies have reported that increases (as occur during the rewarming phase of cardiopulmonary bypass [CPB]) or decreases in brain temperature of a mere 0.5 degrees to 2 degrees C can significantly worsen or improve, respectively, postischemic neurologic outcome. The purpose of the present study was to evaluate a novel approach of selectively cooling the brain during hypothermic CPB and subsequent rewarming. ⋯ The magnitude of selective brain cooling observed in both study groups typically exceeded the 0.5 degrees to 2.0 degrees C change previously reported to modulate ischemic injury, and was most prominent during the latter phases of CPB. When compared with previous research from our laboratory, application of cold forced air to the cranial surface resulted in brain temperatures that were cooler than those observed during hypothermic CPB without pericranial cooling. On the basis of the assumption that similar beneficial brain temperature changes can be induced in humans, we speculate that selective convective brain cooling may enable clinicians to improve neurologic outcome after hypothermic CPB.
-
Comment Letter
Reconstruction plates for internal fixation of flail chest.
-
We assessed the long-term outcome of a glutaraldehyde-preserved bovine pericardial conduit containing a stentless composite porcine aortic valve. ⋯ The SJM Biocor (Belo Horizonte, Brazil) bovine pericardial stentless valved conduit performed well as a substitute for the right ventricle to pulmonary artery connection.