The Annals of thoracic surgery
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We report the case of an 18-year-old patient who underwent Ravitch procedure for pectus carinatum and subsequently had septic shock develop with severe cardiac dysfunction requiring treatment with extracorporeal membrane oxygenation. We advocate the use of extracorporeal membrane oxygenation in adult patients with intractable cardiorespiratory failure due to sepsis post-thoracic surgery unresponsive to conventional therapy.
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Pulmonary gangrene is an extremely rare and severe complication of pneumonia. It is very rarely seen in community-acquired pneumonia. ⋯ His condition rapidly deteriorated with ensuing pulmonary gangrene and septic shock. He was successfully managed by emergency pneumonectomy.
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Randomized Controlled Trial Comparative Study
Intracoronary shunt prevents ischemia in off-pump coronary artery bypass surgery.
The purpose of this study was to evaluate the role of intracoronary shunt during off-pump coronary artery bypass surgery. ⋯ Intracoronary shunt prevents ischemia during grafting of the left anterior descending coronary artery and provides satisfactory immediate- and short-term graft patency.
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Comparative Study
Risks and predictors of blood transfusion in pediatric patients undergoing open heart operations.
Blood transfusion in adults is associated with increased mortality and morbidity after cardiac operations. The aim of this study was to identify the main predictors of blood transfusion and explore the relationship between blood transfusion and adverse outcomes in a pediatric population. ⋯ The amount of blood transfusion is independently associated with infections but not with mortality.
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Comparative Study
The 17-mm St. Jude Medical Regent valve is a valid option for patients with a small aortic annulus.
When aortic valve replacement is performed in patients with a small aortic annulus, prosthesis-patient mismatch is of concern. Such prosthesis-patient mismatch may affect postoperative clinical status and survival. We investigated the outcomes of isolated aortic valve replacement performed with a 17-mm mechanical prosthesis in patients with aortic stenosis. ⋯ Aortic valve replacement with a 17-mm Regent prosthesis appears to provide satisfactory clinical and hemodynamic results in patients with a small aortic annulus. Remarkable left ventricular mass regression during follow-up was achieved irrespective of the effective orifice area index at discharge.