The Annals of thoracic surgery
-
The dual-stage venous cannula is widely used but can obstruct the surgeon's view and interfere with operative procedures in the aortic root. We designed a new stainless steel sheath for a dual-stage venous cannula that enables the cannula to bend and maintain the appropriate angle for the surgical procedures. We suggest that operative procedures in the aortic root can be performed faster during safety cardiopulmonary bypass by use of a dual-stage venous cannula bent by application of this new sheath.
-
The purpose of this study was to evaluate the results of various surgical modalities that have been evolving for the treatment of ventricular septal defect, pulmonary atresia, and major aortopulmonary collateral arteries. ⋯ In single-stage complete unifocalization, more patients had final correction. It reduces the number of operations and hospitalization and hence is more cost effective than multistaged procedures.
-
A 75-year-old woman underwent excision of a middle lobe lung nodule that contained a separate, isolated focus of metastatic papillary thyroid carcinoma. A thyroid lobectomy for papillary cancer had been performed 47 years earlier. This interval is believed to be the longest time from initial diagnosis to identification of distant lung metastasis reported. The pertinent published reports are reviewed and methods of surveillance discussed.
-
Induced hypothermia may be used to reduce metabolism in acute respiratory failure. Hypothermia is accompanied by an increase in pulmonary vascular resistance, as also seen in the early period after lung transplantation. It was our concern that the combination of the two would lead to an increased workload on the right ventricle. ⋯ Induced hypothermia to 32 degrees C after lung transplantation resulted in a significant decrease in the work done by the right ventricle despite a significant increase in pulmonary vascular resistance.
-
Comparative Study Clinical Trial
Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures.
Diabetes mellitus is a risk factor for deep sternal wound infection after open heart surgical procedures. We previously showed that elevated postoperative blood glucose levels are a predictor of deep sternal wound infection in diabetic patients. Therefore, we hypothesized that aggressive intravenous pharmacologic control of postoperative blood glucose levels would reduce the incidence of deep sternal wound infection. ⋯ Use of perioperative continuous intravenous insulin infusion in diabetic patients undergoing open heart surgical procedures significantly reduces major infectious morbidity and its associated socioeconomic costs.