The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Feb 2014
Case ReportsManagement of massive pulmonary hemorrhage following pulmonary endarterectomy.
Massive pulmonary hemorrhage is a potentially fatal complication of pulmonary endarterectomy. We describe a successful management in which the patient's right lower lobe bronchus was occluded with a Fogarty balloon catheter while on peripheral venoarterial extracorporeal membrane oxygenation.
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Thorac Cardiovasc Surg · Feb 2014
Review Case ReportsSurgery for fulminant prosthetic valve endocarditis after transapical transcatheter aortic valve-in-valve implantation.
We report the clinical course of a patient with a history of transapical aortic "valve-in-valve" transcatheter aortic valve implantation (TAVI), actually suffering from prosthetic valve endocarditis. The patient now underwent cardiac surgery as a salvage procedure. ⋯ The present case raises the question, how to deal with high-risk patients, once considered unsuitable for cardiac surgery in presence of prosthetic valve infection? Up to now, there exists only insufficient knowledge about incidence, clinical course, and effectiveness of treatment strategies for prosthetic valve endocarditis after TAVI. A review of the available literature is given.
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Thorac Cardiovasc Surg · Feb 2014
Randomized Controlled Trial Comparative StudyTemporary epicardial pacemaker wires: significance of position and electrode type.
To determine the pacing and sensing properties of different temporary epicardial pacemaker electrodes after cardiac surgery depending on position at the heart and time after surgery. ⋯ 1. Up to postoperative day 10, adequate pacing and sensing performance was achieved by both electrode types in each position. 2. Medtronic electrodes had better pacing thresholds in atrium and ventricle after day 5. 3. Positioning of pacemaker electrodes does not alter functionality. 4. Handling of Osypka electrodes was easier than that of Medtronic electrodes.
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Thorac Cardiovasc Surg · Feb 2014
Comparative StudyImpact of smoking status on outcomes after concomitant aortic valve replacement and coronary artery bypass graft surgery.
There is a paucity of data on the impact of smoking status on outcomes after concomitant aortic valve replacement and coronary artery bypass graft (AVR-CABG) surgery. ⋯ Smoking is not associated with adverse outcomes after concomitant AVR-CABG surgery. Smoking status should not, therefore, preclude these patients from undergoing this procedure. Given the adverse effect of smoking on overall cardiovascular morbidity and mortality and late postoperative mortality, patients should be encouraged to quit smoking.
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Thorac Cardiovasc Surg · Feb 2014
Comparative StudyMinimally invasive versus conventional extracorporeal circulation in minimally invasive cardiac valve surgery.
Minimally invasive extracorporeal circulation (MECC) technology was applied predominantly in coronary surgery. Data regarding the application of MECC in minimally invasive valve surgery are missing largely. ⋯ We were able to prove the feasibility of MECC even in minimally invasive performed mitral and aortic valve procedures. In addition, the use of MECC provides decreased platelet consumption and less hemodilution. The use of MECC in these selected patients lead to a shorter ventilation time and ICU stay.