European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Dec 2010
Randomized Controlled Trial Comparative StudyCold blood versus cold crystalloid cardioplegia: a prospective randomised study of 345 aortic valve patients.
Although experimental studies have indicated that blood cardioplegia may be superior to crystalloid cardioplegia for myocardial protection, clinical data still remain uncertain. In a previous randomised study from our institution, including 1440 patients undergoing coronary artery bypass grafting (CABG), no beneficial effects of blood cardioplegia were seen in any relevant outcome variables. The investigation was therefore extended to a patient population having longer pump times and ischaemic periods. ⋯ There were no indications that retrograde cold blood cardioplegia was superior to retrograde cold crystalloid cardioplegia patients undergoing aortic valve replacement, with or without CABG.
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Eur J Cardiothorac Surg · Dec 2010
Comparative StudyVancomycin plasma concentrations in cardiac surgery with the use of profound hypothermic circulatory arrest.
This study was undertaken to compare the effect of deep hypothermic circulatory arrest, compared with moderate hypothermia, on the plasma concentrations and pharmacokinetic profile of vancomycin, administered as prophylaxis, in patients undergoing cardiac surgery with cardiopulmonary bypass. ⋯ The dosing of vancomycin, if used as antibiotic prophylaxis, does not need to be adjusted in cardiac surgery patients when undergoing profound hypothermic circulatory arrest, since the plasma concentrations and pharmacokinetic profile are similar to patients with moderate hypothermia. The pharmacokinetic profile, consisting of three compartments, was not changed by the differences in temperature.
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Eur J Cardiothorac Surg · Nov 2010
Comparative StudyRisk prediction and outcomes in patients with liver cirrhosis undergoing open-heart surgery.
There are few data assessing factors, which identify patients with liver cirrhosis (LC) facing high risk for open-heart surgery. We sought to compare the Model for End-Stage Liver Disease (MELD) score, the Child-Turcotte-Pugh (CTP) classification and the European system for cardiac operative risk evaluation (EuroSCORE) for risk prediction in cirrhotic patients. ⋯ The mortality of patients with liver cirrhosis undergoing open-heart surgery progressively increases with the severity of liver dysfunction. Therefore, the MELD score most reliably identifies those cirrhotic patients who are at high risk for open-heart surgery.