The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Feb 2010
Comparative StudyMinimizing circulatory arrest by using antegrade cerebral perfusion for aortic arch reconstruction in infants causes fewer postoperative adverse events.
Because deep hypothermic circulatory arrest (DHCA) carries a risk for neurological damage, antegrade cerebral perfusion (ACP) is used increasingly for aortic arch surgery in infants. We assessed the short-term effects of minimal DHCA (< 30 minutes) versus prolonged DHCA (> 30 minutes) during biventricular aortic arch reconstruction. ⋯ Minimal DHCA results in fewer adverse events and a reduced length of stay, compared with prolonged DHCA. Therefore, during aortic arch surgery in infants, DHCA should be minimized by using antegrade cerebral perfusion.
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Thorac Cardiovasc Surg · Feb 2010
Case ReportsIatrogenic tracheal rupture during intubation with a double-lumen tube.
Iatrogenic tracheal rupture after intubation with a double-lumen endotracheal tube is rare. An endobronchial tube positioning guide stylet, which is generally used during intubations with a double-lumen tube, may tear the trachea. A 76-year-old patient with right upper lobe carcinoma was scheduled for videothoracoscopic lobectomy. ⋯ The tear in the membranous part of the trachea was repaired. Use of stylets during intubation may cause tracheal injury. To prevent such an injury, the stylet should be withdrawn after the tip of the tube has passed through the vocal cords.