The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Mar 2008
Comparative StudyImpact of different pacing modes on left ventricular function following cardiopulmonary bypass.
Patients with severely impaired left ventricular (LV) function often demonstrate prolonged inter- and intraventricular conduction. This prospective study investigates hemodynamic effects and outcomes of perioperative temporary biventricular pacing in patients with heart failure undergoing heart surgery. ⋯ In the majority of patients with reduced LV function, temporary biventricular pacing improves CO and arterial blood pressure after surgery, especially when LV dilatation is present.
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Thorac Cardiovasc Surg · Mar 2008
Case ReportsDelayed pericardial tamponade, mitral insufficiency and VSD after stab wound to the heart.
We report a case of delayed pericardial tamponade and presentation of a mitral insufficiency and traumatic ventricular septal defect (VSD) after a cardiac stab wound in an attempted suicide. Delayed tamponade in combination with a VSD and mitral valve injury is a rare complication after a stab wound to the heart. Normal echocardiographic findings, no murmur at admission and relatively benign clinical conditions may be misleading after cardiac trauma. The presented case links the rapid deterioration of the clinical condition and the development of a pericardial effusion to a Valsalva maneuver.
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Thorac Cardiovasc Surg · Mar 2008
Case ReportsUnsuspected location of a ventricular septal defect after blunt chest trauma.
A 40-year-old woman, without previous cardiac symptoms, was referred to our hospital from a local hospital with a subpulmonary ventricular septal defect following blunt chest trauma. The patient was in cardiogenic shock and emergency repair was mandatory. ⋯ Echocardiography is very important for rapid detection. Early repair is necessary and constitutes a lifesaving procedure when hemodynamic instability is present.
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Thorac Cardiovasc Surg · Mar 2008
Correction of coarctation of aorta in adult patients--impact of corrective procedure on long-term recoarctation and systolic hypertension.
Uncorrected coarctation of the aorta in adults predisposes to congestive failure, aortic rupture, stroke and endocarditis. Surgical correction of this condition is fraught with technical difficulties due to the complexity of the lesion, associated anomalies and extensive collaterals. The optimal surgical technique has not yet been well defined in adults. We describe our experience with adult coarctation and the long-term outcome with regard to recoarctation and systolic hypertension. ⋯ Surgical correction of coarctation of aorta in adults can be achieved with an acceptable morbidity. A variety of options are available for the surgical management of coarctation of the aorta in adults. Prosthetic graft and patch repair are associated with good short and long-term results. Use of balloon angioplasty without stenting as the primary therapy requires further clarification. Hypertension is well controlled in most patients.