The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Dec 2005
Cardiac surgery in Germany during 2004: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery.
All cardiac surgical procedures performed in 79 German cardiac surgical units in the year 2004 are presented in this report, which is based on a voluntary registry organized by the German Society for Thoracic and Cardiovascular Surgery. A total of 100 830 cardiac surgical procedures (ICD and pacemaker procedures excluded) were reported to the registry for the year 2004, an increase by 1.1 % compared to the year 2003. ⋯ Hospital mortality in 58 144 isolated CABG procedures (7.1 % off pump) was 2.8 %, and 4.5 % in 18 617 isolated valve procedures. This registry is an important tool of the German Society for Thoracic and Cardiovascular Surgery to allow a continuous and voluntary monitoring of quality and to illustrate the development of cardiac surgery in Germany.
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Thorac Cardiovasc Surg · Dec 2005
Aspirin and clopidogrel taken until 2 days prior to coronary artery bypass graft surgery is associated with increased postoperative drainage loss.
Platelet aggregation inhibitors, such as aspirin and clopidogrel, are associated with increased bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass. We investigated the impact of time between the last intake of aspirin and clopidogrel before CABG surgery and drainage loss, transfusion requirements and rate of reoperation. ⋯ Aspirin and clopidogrel up to 2 days prior to CABG were associated with a significantly higher postoperative drainage loss.
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Thorac Cardiovasc Surg · Dec 2005
Comparative StudyCharacteristic differences between patients who have undergone surgical treatment for lung metastasis or hepatic metastasis from colorectal cancer.
The characteristic differences between patients with lung or liver metastases from colorectal carcinoma (CRC) have not yet been clarified. A small group of these patients demonstrate a better prognosis, and the selection criteria for resection of liver and/or lung metastasis are not well defined. It is important to compare and analyze the most common metastatic sites, which include liver metastases and lung metastases. The objective of this study was to compare the characteristics of the two groups in order to identify patients who benefitted from surgical resection of CRC. ⋯ Candidates for surgical treatment for lung or liver metastases from CRC may be an acceptable for the same valuable approach, even if characteristic differences were observed in each group.
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Thorac Cardiovasc Surg · Dec 2005
Comparative StudySelective cerebral perfusion via right axillary artery direct cannulation for aortic arch surgery.
The risk of neurological complications is still a life-threatening event for patients undergoing proximal aortic arch or total aortic arch surgery. To prevent these complications, axillary artery cannulation and antegrade selective cerebral perfusion were utilized. We compared the effects of using hypothermic circulatory arrest (HCA) alone or with selective cerebral perfusion (SCP/AX) via right side axillary artery direct cannulation. ⋯ Our results suggest that HCA/SCP is superior to HCA alone for preventing cerebral injury during operations on the aortic arch. By reducing embolic risk, as well as the duration of HCA, SCP with axillary artery direct cannulation may be the optimal technique for averting cerebral events, reducing complications, and shortening hospital stays following aortic arch repair.
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Thorac Cardiovasc Surg · Dec 2005
Case ReportsSuccessful use of recombinant factor VIIa in a patient with intractable bleeding during extracorporeal membrane oxygenation.
Bleeding is still the most common complication during extracorporeal membrane oxygenation (ECMO) for temporary cardio-circulatory support. We present a case of a young man suffering from intractable hemorrhage during ECMO support, who was pre-treated with glycoprotein IIb/IIIa receptor antagonist Tirofiban due to a suspicion of myocardial ischemia. After failure of conventional hemostatic means, hemostasis was achieved by the donation of recombinant Factor VIIa (rFVIIa). Aspects of bleeding control during extracorporeal circulatory support, the use of Tirofiban and rFVIIa are discussed.