European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Apr 2008
Early neurological complications after coronary artery bypass grafting and valve surgery in octogenarians.
To determine the incidence and risk factors for neurological events complicating cardiac surgery, and the implications for operative outcome in octogenarians. ⋯ Octogenarians undergoing on-pump CABG and/or valve repair/replacement are at higher risk of neurological dysfunction, from which the majority recover fully. The adverse implications for operative mortality and morbidity, however, are profound. Blood product transfusion which has a powerful correlation with neurological complication should be reduced by rigorous haemostasis with parsimonious use of sealants when appropriate.
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Eur J Cardiothorac Surg · Apr 2008
Case ReportsNot letting the left side know what the right is doing!
Arrhythmogenic right ventricular dysplasia (ARVD) encompasses a spectrum of presentations including ventricular tachycardia, sudden cardiac death and heart failure. Complete right ventricular disarticulation was effective in a young athletic male who was refractory to drug therapy and experienced recurrent shock therapies from an implantable cardioverter-defibrillator that were incapacitating. The case highlights the challenging management of ARVD despite over two decades of research and the resurgent interest in ventricular disarticulation.
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Eur J Cardiothorac Surg · Mar 2008
The optimal technique for combined application of fibrin sealant and bioabsorbable felt against alveolar air leakage.
The combination of fibrin sealant and bioabsorbable sheet is known to provide a better sealing effect on alveolar air leakage compared to the single use of fibrin sealant. However, there is little evidence that reveals the optimum techniques for their combined application. Presently we developed a novel Rub + Soak B method that comprises the attachment of thrombin-impregnated sheet to the fibrinogen-rubbed lung tissue area. This study aimed to evaluate its sealing effect compared to various combined application techniques. ⋯ The novel Rub+Soak B technique was the most effective and reasonable combination technique wherein the sealing mechanism was supported by the physical properties of the fibrin sealant components.
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Eur J Cardiothorac Surg · Mar 2008
Comparative StudyLate dialysis rate for coronary artery bypass grafting patients with moderate-to-severe renal impairment: comparison between off-pump and conventional method.
Whether off-pump coronary artery bypass grafting has a late renal protective advantage over conventional coronary arterial bypass grafting with cardiopulmonary bypass use is controversial. ⋯ Patient characteristics, rather than operative strategy of using off-pump or conventional coronary artery bypass grafting, influence the mid-term mechanical renal replacement therapy rate for patients with glomerular filtration rates <60 ml/min.
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Eur J Cardiothorac Surg · Mar 2008
Review Meta AnalysisExtracorporeal membrane oxygenation after cardiac arrest in children: what do we know?
The use of extracorporeal membrane oxygenation (ECMO) as a resuscitative measure during or after manual cardiopulmonary resuscitation (CPR) shows sharply contrasting results. To assess the added value of ECMO in this situation and looking for predictors of mortality we performed a meta-analysis of individual patients collected from observational studies. An electronic Pubmed search restricted to English language publications between 1990 and 2007 using a consensus restrictive criterion retrieved 462 titles. ⋯ Age and weight do not seem to influence mortality. The incidence of complications is high, particularly neurological and renal, having a strong influence on survival. The specific characteristics of the neurological complications and their long-term effects on survivors are poorly reported in the literature.