European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2002
Comparative StudyWarm retrograde blood cardioplegia saves more ischemic myocardium but may cause a functional impairment compared to cold crystalloid.
Ongoing ischemia, or even ischemia in progress, is regularly encountered in today's patients amenable to cardiac surgery. We set out to assess the effect of 'active resuscitation' during cardioplegia with warm continuous retrograde blood cardioplegia (WB) in a protocol simulating a clinical situation. ⋯ CC did reduce the size of the infarction by about 10% compared to control animals, whereas WB reduced the infarction by more than 50% of that seen after CC. Both modalities are, however, associated with a functional reduction during the first 60 min of reperfusion, WB being the worst.
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Eur J Cardiothorac Surg · Sep 2002
Six-year prospective audit of chest reopening after cardiac arrest.
To identify which patients benefit from chest reopening after cardiac arrest. ⋯ This study strongly confirms the benefit of chest reopening after cardiac arrest in the cardiac surgical ICU. Patients who arrest within 24 h of surgery and in whom reopening is instituted within 10 min are particularly likely to benefit. The value of chest reopening in arrests outside the ICU remains unresolved. All patients reopened on the ward died, suggesting that this practice should be discontinued. Early 'scoop and run' resulted in one solitary survivor though it should probably be restricted to patients who arrest within 72 h of surgery as surgically remediable problems are unlikely after this time.
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Eur J Cardiothorac Surg · Sep 2002
Case ReportsIatrogenic left main and proximal right coronary artery stenoses after aortic valve replacement.
Iatrogenic left main coronary artery stenosis after aortic valve replacement is an infrequent but potentially life-threatening complication. A 44-year-old woman who had normal coronary arteries documented by preoperative coronary angiogram, and who developed severe stenosis of the left main coronary artery and subtotal occlusion of the proximal right coronary artery after aortic and mitral valve replacements is presented. ⋯ Accurate diagnosis was confirmed by repeat coronary angiography. She underwent successful coronary artery bypass grafting.