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 2011
Randomized Controlled Trial Multicenter StudyWarm-blood cardioplegia with low or high magnesium for coronary bypass surgery: a randomised controlled trial.
Magnesium (Mg²⁺) is cardioprotective and has been routinely used to supplement cardioplegic solutions during coronary artery bypass graft (CABG) surgery. However, there is no consensus about the Mg²⁺ concentration that should be used. The aim of this study was to compare the effects of intermittent antegrade warm-blood cardioplegia supplemented with either low- or high-concentration Mg²⁺. ⋯ Warm-blood cardioplegia supplemented with 16 mmol l⁻¹ Mg²⁺, compared with 5 mmol l⁻¹ Mg²⁺, does not reduce the frequency of postoperative atrial fibrillation in patients undergoing CABG but may reduce cardiac injury. (This trial was registered as ISRCTN95530505.).
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Eur J Cardiothorac Surg · Sep 2011
ReviewModified simple sliding aortoplasty for preserving the sinotubular junction without using foreign material for congenital supravalvar aortic stenosis.
The surgical approach for treating supravalvar aortic stenosis (SVAS) has evolved from a plain patch technique to a three-dimensional patch repair, which has some drawbacks. Here, we report on the midterm outcomes after using our modified simple sliding aortoplasty preserving sinotubular junction without foreign material for surgical correction of SVAS. ⋯ Our modified simple sliding aortoplasty showed excellent surgical results, and may be a good option for discrete SVAS.
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Eur J Cardiothorac Surg · Sep 2011
Multicenter Study Clinical TrialClinical experience with the ATS 3f Enable® Sutureless Bioprosthesis.
The ATS 3f Enable® Bioprosthesis is a self-expanding valve with a tubular design that allows for decreased leaflet stress and preservation of aortic sinuses. We report the midterm results of a prospective, multicenter clinical study evaluating the safety and efficacy of this stented bioprosthesis in patients undergoing isolated aortic valve replacement with or without concomitant procedures. ⋯ The sutureless valve implantation technique is feasible and safe with the ATS 3f Enable Bioprosthesis. Valve implantation resulted in excellent hemodynamics and significant clinical improvement. Overall, these data confirm the safety and clinical utility of the Enable® Bioprosthesis for aortic valve replacement.
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Eur J Cardiothorac Surg · Sep 2011
Extracorporeal membranous oxygenation support for acute fulminant myocarditis: analysis of a single center's experience.
Acute fulminant myocarditis (AFM) is a disease category that is easily neglected. Circulatory mechanical support is sometimes required for this devastating condition. We analyzed our experience in managing AFM with mechanical circulatory support. ⋯ AFM still carries high mortality rates in spite of advanced mechanical support. Most of the survivors did not require transplantation and could return to good lifestyle. Due to its simplicity and effectiveness, ECMO can be a first-line tool to rescue this group of patients.
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Eur J Cardiothorac Surg · Sep 2011
Logistic risk model predicting postoperative renal failure requiring dialysis in cardiac surgery patients.
Renal failure requiring dialysis represents a serious complication following cardiac surgery. This study was designed to determine the incidence and predictors of renal failure requiring dialysis in a contemporary patient population. We also aimed to create a model based on these risk factors that could serve as a tool for the prediction of renal failure requiring dialysis. ⋯ Renal failure requiring dialysis remains a serious complication, particularly in patients with pulmonary hypertension and previous renal dysfunction. Our logistic risk model allows the prediction of renal failure requiring dialysis, based on the individual presentation of risk factors and, therefore, helps to determine the perioperative risk in cardiac surgery patients.