European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 2009
Case ReportsMassive systemic air embolism during off-pump coronary artery surgery.
In OPCAB (off-pump coronary artery bypass) operations, development of cardiac arrest during the distal anastomosis to obtuse marginal coronary artery leads to significantly low blood pressure in the ascending aorta. Therefore, blowing of compressed air in high flow on not-slinged coronary artery may cause air mobilization from the coronary artery system into the ascending aorta that may result in severe brain damage.
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Eur J Cardiothorac Surg · Jan 2009
Reduced incidence of atrial fibrillation after cardiac surgery by continuous wireless monitoring of oxygen saturation on the normal ward and resultant oxygen therapy for hypoxia.
Monitoring of cardiac surgical patients after transfer from the intensive care unit to the normal ward is incomplete. Undetected hypoxia, however, is known to be a risk factor for occurrence of atrial fibrillation. We have utilized Auricall for continuous wireless monitoring of oxygen saturation and heart rate until discharge. The object of the study was to analyze if oxygen therapy as a result of Auricall alerts of hypoxia can decrease the incidence of postoperative atrial fibrillation. ⋯ Continuous monitoring of oxygen saturation on the normal ward and subsequent oxygen therapy for hypoxia can reduce the incidence of atrial fibrillation in a subgroup of patients after cardiac surgery. Prospective randomized trials are warranted to confirm these data.
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Eur J Cardiothorac Surg · Jan 2009
Infective endocarditis in children: native valve preservation is frequently possible despite advanced clinical disease.
Recent reports describing surgical experiences with childhood IE are sparse. We sought to determine patient-specific characteristics and their impact on outcome for children with infective endocarditis (IE) undergoing surgical intervention. We therefore reviewed all cases of culture-proven IE referred for surgical intervention at our institution over the last three decades. ⋯ Children undergoing surgery for infective endocarditis frequently have advanced disease with embolic complications and double valve involvement. However, preservation of the native valve is frequently possible. Need for valve replacement is suggested by leaflet thickening and embolization. Despite the advanced pathology, survival and functional outcomes are favorable.