The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Apr 1999
Case ReportsMinimally invasive extirpation of a left-ventricular myxoma.
As myxomas usually are benign neoplasms a minimally invasive technique would be an interesting alternative for their extirpation because the surgical trauma is reduced. In one male patient with a diagnosed left-ventricular myxoma minimally invasive surgery was carried out using the Port-Access method. 2D echocardiography, EBT, and MRI were performed preoperatively to obtain exact information about topography, calcifications, and malignity. ⋯ Histopathological examination revealed a cardiac myxoma extirpated in toto. At one-year follow-up there was no recurrence of the tumor.
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Thorac Cardiovasc Surg · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialReducing the post-pump syndrome by using heparin-coated circuits, steroids, or aprotinin.
Cardiopulmonary bypass (CPB) induces a systemic inflammatory response called 'post-pump syndrome'. As a part of a complex interaction between white cells and vascular endothelium, proinflammatory cytokines IL-6 and IL-8 are part of a phased immune response that is also balanced by anti-inflammatory cytokines such as IL-10. We compared the influence of heparin-coated circuits, steroids, and aprotinin on these cytokines, looking for ways to reduce the syndrome. ⋯ The results show a similar reduction of the inflammatory cytokine release (IL-6 and IL-8 as markers) using early steroid application and aprotinin in high dosage. Heparin coating reduces IL-6 and increases IL-10 release, whereas IL-8 is not affected. Further studies should investigate the effects of a combined application for reducing inflammatory cytokine release and the post-pump syndrome.