The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Dec 2009
Postoperative treatment of carvedilol following low dose landiolol has preventive effect for atrial fibrillation after coronary artery bypass grafting.
Postoperative atrial fibrillation (AF) is the most common complication after coronary artery bypass grafting (CABG). We have reported that the intra- and perioperative administration of landiolol has a preventive effect on postoperative AF in the early postoperative period after CABG surgery. The purpose of this study was to investigate the prophylactic effect of postoperative treatment with carvedilol following landiolol against postoperative AF. ⋯ Postoperative treatment with carvedilol following landiolol has the effect of preventing tachycardia during AF after coronary artery bypass grafting.
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Thorac Cardiovasc Surg · Dec 2009
The impact of pre- and postoperative renal dysfunction on outcome of patients undergoing coronary artery bypass grafting (CABG).
Acute changes in renal function after elective coronary bypass surgery represent a challenging clinical problem. In this study, we evaluated perioperative risk factors for the development of postoperative renal dysfunction (PRD), and the impact of such an event on the perioperative course. Additionally, we investigated the influence of preoperatively mildly increased serum creatinine on perioperative mortality and morbidity. ⋯ Mild renal dysfunction preoperatively is an important predictor of outcome after CABG. In these patients, PRD dramatically increases mortality, morbidity and length of hospital stay.
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Thorac Cardiovasc Surg · Oct 2009
Case ReportsTraumatic arteriovenous fistula of the internal mammary vessels.
An uncommon case of traumatic arteriovenous fistula of the left internal mammary artery following penetrating chest trauma is presented. The patient developed a left parasternal machinery murmur six days after thoracotomy to repair a pericardial tamponade after a penetrating left parasternal stab wound. Selective digital subtraction angiography revealed pseudoaneurysm formation with fistulous connection of the left internal mammary artery to the adjacent vein. The fistula was successfully occluded with coil embolization.
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Readmission to the intensive care unit (ICU) after cardiac surgery is associated with higher costs and may be correlated with an increased mortality. We wanted to evaluate predictors of ICU readmission and to analyze the outcome of those patients. ⋯ Patients after valve/combined surgery are more likely to require readmission to the ICU. Respiratory complications were the most common reasons for readmission. To reduce the readmission rate, it is necessary to treat cardio-respiratory problems early, particularly in patients showing predictive risk factors.
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Thorac Cardiovasc Surg · Oct 2009
Combined aortic root and right ventricular outflow tract replacement with mechanical conduits in adult patients after repeated surgery for congenital heart disease.
To manage aortic root aneurysms and right ventricular outflow tract (RVOT) graft dysfunction in adult patients after repeated surgery for congenital heart disease, we performed combined prosthetic aortic root and RVOT replacement. ⋯ Combined aortic root and RVOT replacement with mechanical conduits in adult patients after repeated surgery for congenital heart disease is a complex operation requiring long CPB time. However, this procedure has the potential to avoid a predictable reoperation associated with conventional biological graft replacement.