The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Apr 2004
Comparative StudyChanges in regional cerebral blood flow under hypothermic selective cerebral perfusion.
Currently the most frequently used perfusion technique during aortic arch surgery to prevent cerebral damage is hypothermic selective cerebral perfusion (SCP). Changes in cerebral blood flow (CBF) are known to occur during these procedures. We investigated regional changes of CBF under conditions of SCP in a porcine model. ⋯ SCP improves CBF in all regions of the brain. Our study characterizes the brain specific hierarchy of blood flow during SCP and total body perfusion. These dynamics are highly relevant for clinical strategies of perfusion.
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Thorac Cardiovasc Surg · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialPerfusion temperature during cardiopulmonary bypass does not affect serum S-100beta release.
The potentially harmful effects of normothermia on neurological outcome during cardiopulmonary bypass (CPB) are controversial. ⋯ The similar pattern of S-100beta release without evident neurological complications in the normothermia group does not suggest an increase in cerebral injury during normothermic CPB.
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Thorac Cardiovasc Surg · Dec 2003
Procalcitonin is a valuable prognostic marker in cardiac surgery but not specific for infection.
The prognostic value of elevated serum levels of procalcitonin (PCT) in patients early after cardiac surgery on cardiopulmonary bypass (CPB) remains unclear. In a prospective study, we investigated whether PCT is useful as a prognostic marker in cardiac surgery with respect to mortality, complications and infections, and whether PCT is a specific marker for occurrence of infections. ⋯ High levels of PCT are associated with mortality, infections, and severe complications early after cardiac surgery using cardiopulmonary bypass and therefore provide a valuable prognostic marker. However, PCT does not discriminate between infectious and non-infectious complications.
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Thorac Cardiovasc Surg · Dec 2003
Chylothorax: a complication following lung resection in patients with NSCLC - chylothorax following lung resection.
Chylothorax following lung resection is not as rare as a postoperative complication as previously reported due to systematic lymph node dissection in patients undergoing lung resection for NSCLC. ⋯ These results suggest that the site of operation, type resection, and technique of systematic nodal dissection, tumour histology and disease stage do not influence the development of chylothorax in patients with NSCLC. The chylous fistula following lung resection for NSCLC tends to close spontaneously.
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Thorac Cardiovasc Surg · Dec 2003
Initial experiences with the Impella device in patients with cardiogenic shock - Impella support for cardiogenic shock.
We planned a study to assess the safety, feasibility, and efficacy of the Impella micro-axial blood pump in patients with cardiogenic shock. ⋯ Left ventricular unloading with the Impella pump via the transthoracic or femoral approach is feasible and safe. Support led to a decrease in pulmonary capillary wedge pressure, increase in cardiac output and mean blood pressure, and improved organ perfusion in patients with severe cardiogenic shock.