The Annals of thoracic surgery
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Previously, neurologic dysfunction was estimated to complicate 25% or less of pediatric open-heart operations. We sought to determine the current incidence and spectrum of early postoperative neurologic complications. ⋯ This review suggests a decrease in acute neurologic morbidity after pediatric open heart operation. Clinical seizures remain the most common complication. Posttransplant, cyclosporin-associated seizures have emerged as an important etiologic category, coincident with an increase in cardiac transplantation in children.
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Air leaks prolong hospital stay. ⋯ Steroid use, male gender, a large leak, a leak with a pneumothorax, and having a lobectomy are all risk factors for a persistent leak. Discharge on a Heimlich valve is safe and effective for patients with a persistent leak unless the leak is an expiratory 5 or more. Once home on a valve, most air leaks will seal in 2 weeks; if not, chest tubes can be safely removed regardless of the size of the leak or the presence of a pneumothorax.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intracoronary shunts reduce transient intraoperative myocardial dysfunction during off-pump coronary operations.
This study investigated the hemodynamic changes in patients undergoing multiple vessel beating heart coronary revascularization in the presence or absence of an intracoronary shunt. ⋯ Stabilization of the left anterior descending coronary artery to perform the anastomosis resulted in temporary hemodynamic changes, which are prevented by the use of an intracoronary shunt. The hemodynamic deterioration during the construction of the posterior descending coronary artery and circumflex coronary artery anastomoses is transient in the shunt group, whereas the snaring technique is associated with an impairment of early functional recovery.
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Comparative Study
Hospital readmission after coronary artery bypass grafting: are women doing worse?
In studies of gender effects on outcome after coronary artery bypass grafting, early mortality has consistently tended to be higher among women, whereas long-term results have varied. The aim of this study was to identify predictors of hospital readmission and assess the effect of gender. ⋯ This study showed an acceptable risk of readmission after coronary artery bypass grafting. Women more often had risk factors related to readmission. However, given identical disease severity, the risk was similar in men and women.