European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2013
Systolic time intervals vs invasive predictors of fluid responsiveness after coronary artery bypass surgery.
Haemodynamic parameters for predicting fluid responsiveness in intensive care patients are invasive, technically challenging or not universally applicable. We compared the initial systolic time interval (ISTI), a non-invasive measure of the time interval between the electrical and mechanical activities of the heart measured by impedance cardiography, with invasively measured haemodynamic parameters in predicting fluid responsiveness after cardiac surgery. ⋯ Non-invasively measured ISTI is able to predict and monitor fluid responsiveness after cardiac surgery non-inferiorly to invasively measured haemodynamic indices.
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Eur J Cardiothorac Surg · Nov 2013
First serial in vivo results of mechanical circulatory support in children with a new diagonal pump.
Mechanical circulatory support (MCS) is a rescue therapy for infants and children suffering from severe cardiorespiratory failure with specific system-related complications like bleeding, thromboembolism and device failure. Novel circuit components for temporary MCS with improved haemodynamic properties may improve patients' outcome and reduce system-related morbidities. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a newly designed rotational pump with a diagonally streamed impeller that can be used in children of all ages (priming volume 16 ml, flow 0-8 l/min). The aim of this study was to analyse the feasibility and safety of the DP3 pump system in children. ⋯ The use of the Deltastream DP3 seems to be safe and effective for MCS in children and may show a low degree of haemolysis. We observed no system-related complications and an overall good outcome in this demanding patient cohort.
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Eur J Cardiothorac Surg · Nov 2013
Total aortic arch replacement with the frozen elephant trunk technique: 10-year follow-up single-centre experience.
Since August 2001, the frozen elephant trunk (FET) technique has been used at our institution to treat degenerative or dissecting aneurysms involving the aortic arch and descending aorta as a potential 'single-stage' procedure. The aim of this study was to review our FET experience and to present the 10-year results. ⋯ An FET concept adds to the armament of the surgeon in the treatment of complex and diverse aortic arch pathologies. The preoperative patient risk profile explains the postoperative morbidity and in-hospital mortality. The FET can potentially be still a 'one-stage' procedure in selected patients. However, the extension of FET to patients with extensive aortic aneurysms has led to an increase in second-stage procedures.
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Eur J Cardiothorac Surg · Nov 2013
Five-year follow-up of drug-eluting stents implantation vs minimally invasive direct coronary artery bypass for left anterior descending artery disease: a propensity score analysis.
The spread of drug-eluting stents (DES) has reduced the incidence of early restenosis following percutaneous coronary interventions (PCI). Meanwhile, development of minimally invasive coronary artery bypass surgery (MIDCAB) has offered a valuable alternative to conventional sternotomy with preservation of the benefit of the internal mammary artery use. Therefore, the revascularization of the left anterior descending (LAD) artery is suitable for both techniques. However, few data with long-term comparison of these two techniques exist. ⋯ MIDCAB and DES implantation showed similar rates of survival but despite an expected lower rate of reintervention on the targeted vessel with DES use, a highly significant higher MACCE rate was observed in the PCI group at 5-year follow-up.