Texas Heart Institute journal
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Comparative Study
Anterolateral minithoracotomies for the radical correction of congenital heart diseases.
During the past 10 years, minimally invasive surgical techniques have been applied more and more widely in both adult and pediatric populations, especially in female patients. Right anterolateral minithoracotomy is an alternative to median sternotomy that yields a better cosmetic outcome. From May 1997 through September 2008, 132 patients (107 females, 25 males) underwent open-heart surgery through right anterolateral minithoracotomy. ⋯ All patients had gratifying cosmetic results at longer follow-up. Indeed the mortality and morbidity rates obtained through our approach were almost the same as those obtained through median sternotomy, and there were no significant differences in cardiopulmonary bypass time, aortic cross-clamp time, ventilation time, or postoperative hospital stay. We conclude that the right anterolateral minithoracotomy for correction of congenital heart defects offers superior cosmetic results without increasing morbidity or mortality rates and confers upon patients psychological and social satisfaction.
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Case Reports
Pericardial tamponade consequent to a dynamite explosion: blast overpressure injury without penetrating trauma.
Acute cardiac tamponade is a life-threatening emergency that requires prompt treatment by either percutaneous or surgical pericardiocentesis. It may occur after penetrating or blunt chest trauma. ⋯ Physicians should be aware of the possibility of pericardial tamponade in victims of barotraumatic events such as dynamite or bomb explosions, even in the absence of penetrating trauma. Cardiac tamponade, although life-threatening, is easy to treat when recognized.
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There are few published reports of the results of supravalvular aortic stenosis correction with the use of Brom's 3-patch technique. Herein, we report our use of this procedure and the short-term results therefrom. From 2002 through 2007, 9 children underwent surgical correction of localized supravalvular aortic stenosis at our hospital. ⋯ In all 8 patients who survived, postoperative transaortic blood pressure gradients were improved (range, 0-16 mmHg), and no repeat operations were needed after 6 to 55 months' follow-up. We consider Brom's technique to be safe in the repair of supravalvular aortic stenosis. In our limited series, it produced effective anatomic restoration, with good short-term and potentially good long-term results.
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Review Meta Analysis
Statin therapy may influence the incidence of postoperative atrial fibrillation: what is the evidence?
Atrial fibrillation is the most common postoperative arrhythmia in patients who undergo cardiac surgery. We sought to determine whether the administration of statins reduces the incidence of postoperative atrial fibrillation in cardiac surgery patients. We performed a meta-analysis on all studies published between 2004 and 2008 that reported comparisons between statin treatment or nontreatment in these patients. ⋯ In studies wherein only coronary artery bypass grafting was performed, statin treatment decreased postoperative atrial fibrillation (OR, 0.64; 95% CI, 0.43-0.95). We conclude that statin administration results in a reduction in the incidence of atrial fibrillation in patients who undergo cardiac surgery. Further research into the underlying mechanism can elucidate possible relationships between the dosage and type of statin used.