European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2005
Recombinant activated factor VII in the management of life-threatening bleeding in cardiac surgery.
Massive perioperative bleeding is a potential complication of cardiac surgery, and may persist despite conventional interventions. RFVIIa is being increasingly used as additional therapy, and the aim of the present study was to describe our experience with rFVIIa in the management of life-threatening bleeding in adult cardiac surgery. ⋯ RFVIIa was successfully used as an additional therapy both during and after cardiac surgery, when bleeding was refractory to conventional methods. Bleeding stopped eventually in all patients and none of the patients exsanguinated.
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Eur J Cardiothorac Surg · Aug 2005
Randomized Controlled Trial Clinical TrialTemporary left ventricular pacing improves haemodynamic performance in patients requiring epicardial pacing post cardiac surgery.
In the 1990s, sequential atrio-ventricular pacing demonstrated haemodynamic benefit relative to right ventricular pacing in patients with sinus rhythm requiring pacing post cardiopulmonary bypass. The benefit of biventricular pacing has been demonstrated in non-surgical patients with severe left ventricular dysfunction. It was hypothesised that left ventricular pacing would increase cardiac output in surgical patients. We report the findings of a prospective trial of left ventricular pacing with active lead placement on the anterior or posterior left ventricular surface, compared to standard practice of active lead placement on the right ventricular surface. ⋯ Left ventricular pacing with active lead placed on the postero-lateral left ventricular wall affords haemodynamic benefit to cardiac surgical patients.
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Eur J Cardiothorac Surg · Aug 2005
Surgery for right ventricle to pulmonary artery conduit obstruction: risk factors for further reoperation.
To identify the surgical approaches and risk factors which influence longevity of right ventricle to pulmonary artery (RV-PA) conduits following first reoperation for obstruction. ⋯ Our results support the optimal surgical approach for RV-PA conduit obstruction is total replacement with a xenograft. RV outflow reconstruction by other techniques without complete dissection of PA bifurcation does not completely relieve the stenosis and could cause early restenosis. Higher systolic gradients at discharge and younger age at first reoperation are predictors of earlier reoperation.
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Eur J Cardiothorac Surg · Aug 2005
Case ReportsAortic arch embolization of an Amplatzer occluder after an atrial septal defect closure: hybrid operative approach without circulatory arrest.
Percutaneous closure of the secundum type atrial septal defects is becoming increasingly popular. We report the case of a 49-year-old man who presented for an unusual embolization of an Amplatzer occluder (AO) 6 weeks after a percutaneous closure of his secundum type atrial septal defect. Emergency cardiac surgery was performed and the device was safely removed by a combined surgical and endovascular approach with no need of circulatory arrest or of profound hypothermia.
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Eur J Cardiothorac Surg · Aug 2005
Cervical esophagogastric anastomosis with a new stapler in the surgery of esophageal carcinoma.
A new reusable circular stapler for cervical esophagogastric anastomosis (CEGA) has been used to substitute the traditional method of hand-sewn cervical anastomosis. ⋯ The results indicate that CEGA using the new circular stapling device in surgery of the esophageal carcinoma is a very effective procedure to improve the anastomotic technique from a traditional hand-sewn anastomosis to a stapled anastomosis and can reduce the incidence of complications.