The Annals of thoracic surgery
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Clinical Trial Controlled Clinical Trial
Effects of autologous platelet concentrate reinfusion after open heart surgery in patients with congenital heart disease.
Plasma pheresis and reinfusion of platelet-rich plasma has not been shown to reduce blood loss in cardiac patients. Recently, freshly prepared autologous platelet concentrates (PC) can be made from patient's blood and has a higher concentration than conventional platelet rich plasma. In this study, the effects of autologous PC reinfusion were examined after open heart surgery in patients with congenital heart disease. ⋯ Reinfusion of the freshly prepared autologous PC was followed by good aggregation responses and low blood loss in patients with noncyanotic congenital heart disease after open heart surgery. This procedure may be useful in pediatric open heart surgery without blood transfusion or with little administration of homologous blood products.
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Review Case Reports
Delayed cardiac tamponade after coronary artery laceration.
Delayed cardiac tamponade after laceration of a coronary artery is unusual and uncommonly reported in the literature. We describe a patient in whom this potentially fatal complication developed 8 days after a stab wound to his chest. In our review of the English language literature we identified only one other report of delayed tamponade after coronary artery laceration.
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Postoperative cognitive dysfunction after cardiac surgery has been attributed both to embolic events and periods with reduced cerebral perfusion. We investigated whether cognitive dysfunction after coronary surgery is associated with changes in regional cerebral blood flow (CBF) using single photon emission computed tomography. ⋯ The significant decrease in CBF after coronary surgery was uniformly distributed and was not correlated to postoperative cognitive dysfunction.
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This clinical study was undertaken to evaluate changes in motor evoked potentials (MEPs) during cold blood infusion into a thoracoabdominal aortic aneurysm. We also determined the efficacy of this infusion method for predicting spinal cord injury during thoracoabdominal aortic aneurysmal surgery. ⋯ Cold blood infusion into the aneurysm while monitoring MEPs was a useful adjunct to detect the presence of critical intercostal arteries and to facilitate thoracoabdominal aortic aneurysmal surgery.
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Deterioration of gas exchange during one lung ventilation (OLV) is caused by both total collapse of the nondependent lung and partial collapse of the dependent lung. A previous report demonstrated that an alveolar recruitment strategy (ARS) improves lung function during general anesthesia in supine patients. The objective of this article was to study the impact of this ARS on arterial oxygenation in patients undergoing OLV for lobectomies. ⋯ Alveolar recruitment of the dependent lung augments PaO2 values during one-lung ventilation.