European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Jul 2005
Comparative StudyThe sealing effect of fibrin glue against alveolar air leakage evaluated up to 48 h; comparison between different methods of application.
There is little experimental evidence to show how much positive airway pressure fibrin sealants can actually withstand, and in particular, how this effect changes over time. In the present study, we experimentally evaluated the sealing effect of fibrin glue against alveolar air leakage up to 48 h after application. ⋯ The results show that the sealing effect of fibrin glue is relatively unstable up to 12h after its application. Rubbing and spray method may help the fibrin seal to reach its full strength faster compared with the other two methods.
-
Eur J Cardiothorac Surg · Jul 2005
Thoracic epidural anesthesia does not improve the incidence of arrhythmias after transthoracic esophagectomy.
The incidence of arrhythmias related to an esophagectomy is high, and its clinical significance has been well accepted. Thoracic epidural anesthesia (TEA) can modulate the sympathetic tone and neuroendocrine responses associated with major operation. This study was aimed to evaluate the effects of TEA on the incidence of arrhythmias in transthoracic esophagectomy patients. ⋯ This result shows that TEA was not beneficial to reduce the incidence of arrhythmias in the transthoracic esophagectomy patients.
-
Eur J Cardiothorac Surg · Jul 2005
Case ReportsUse of a modified endobronchial tube for mechanical ventilation of patients with bronchopleural fistula.
Mechanical ventilation in patients with bronchopleural fistula after lung resection is a major problem, as it causes increase of the air-leak, complicates the healing process and makes residual lung tissue ventilation difficult. We present two cases in which the use of a modified double lumen endobronchial tube improved ventilation and eliminated the fistula air-leak. We used a right-sided double lumen sher-i-bronch tube (Sheridan Catheter Corp., USA). ⋯ In both the patients treated with this technique, we obtained a good expansion of the residual parenchyma. Despite the procedure, the first patient died of septic shock; in the second patient, we achieved improvement of the respiratory function, the weaning from the mechanical ventilation, and thereafter, the healing of the fistula. The use of a modified double lumen sher-i-bronch tube in mechanically ventilated patients with post-resection bronchopleural fistula allows the anaesthesiologist to suction separately the two lungs and to ventilate adequately the remaining lung tissue, thus obtaining the lung reexpansion and the consequent reduction of the residual pleural space, and facilitating the healing of the fistula.
-
Eur J Cardiothorac Surg · Jul 2005
Homograft reconstruction of the aortic root for endocarditis with periannular abscess: a 17-year study.
The study was conducted to evaluate the long-term results of homograft reconstruction of the left ventricular outflow tract with a cryopreserved aortic homograft in the presence of aortic root abscess associated with a biofilm bacterial infection. ⋯ Radical debridement of the infected aortic root and homograft ARR offer a low recurrent infection rate and an overall low valve-related morbidity and mortality for up to 17 years. The antibiotic permeable cryopreserved homograft has proven to be resistant to biofilm bacterial infection.
-
Eur J Cardiothorac Surg · Jul 2005
Small ischemic brain lesions after cardiac valve replacement detected by diffusion-weighted magnetic resonance imaging: relation to neurocognitive function.
Following coronary artery bypass graft surgery, some studies using magnetic resonance imaging (MRI) have demonstrated new small ischemic brain lesions in patients without apparent neurological deficits. We aimed to prospectively evaluate brain injury after cardiac valve replacement using MRI and to determine the relationship to neurocognitive function. ⋯ Following cardiac valve replacement, new small ischemic brain lesions were detected by diffusion-weighted MRI. Neurocognitive decline was present early after operation, but resolved within 4 months. A correlation of new ischemic lesions to postoperative cognitive dysfunction or clinical variables was not found.