The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Aug 2009
Randomized Controlled TrialBeneficial effects of intravenously administered N-3 fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a prospective randomized study.
Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting operation (CABG). Experimental data have shown antiarrhythmic effects of n-3 polyunsaturated fatty acids (PUFA) on myocardial cells. Orally administered PUFA could significantly reduce the rate of postoperative AF. We assessed the efficacy of PUFA for the prevention of AF after CABG. PUFA were given intravenously to prevent variation in bioavailability. ⋯ Perioperative intravenous infusion of PUFA reduces the incidence of AF after CABG and leads to a shorter stay in the ICU and in hospital. Our data suggest that perioperative intravenous infusion of PUFA should be recommended for patients undergoing CABG.
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We discuss the etiology and incidence of iatrogenic pneumothorax (IPnx) which can develop after invasive procedures performed for diagnostic and/or therapeutic purposes, and the efforts to prevent this complication and its consequences. ⋯ At training hospitals the incidence of IPnx will increase in parallel to the increase in invasive procedures. Invasive procedures should be performed by experienced personnel or under their supervision when risk factors are involved.
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Thorac Cardiovasc Surg · Aug 2009
Case ReportsLife-threatening airway obstruction due to retropharyngeal and cervicomediastinal hematomas following stellate ganglion block.
Airway obstruction by retropharyngeal or cervicomediastinal hematomas following stellate ganglion block is life-threatening. The onset of the initial symptoms of retropharyngeal or cervicomediastinal hematoma usually occurs 2 hours or more after stellate ganglion block. We report the rare complication of airway obstruction leading to respiratory arrest caused by retropharyngeal and cervicomediastinal hematomas due to rebleeding of an ascending cervical artery 3 days after stellate ganglion block.
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Temporary aspirin resistance can occur during the post-CABG period. If the factors causing resistance can be identified, the incidence of early graft occlusions can also be minimized. ⋯ Aspirin resistance is encountered during the early postoperative period in the majority of patients undergoing CABG. None of the factors studied were found to be causative for resistance formation. Further studies are required to clarify this entity.