European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Oct 2007
Randomized Controlled Trial Comparative StudyEffects of normothermic organ bath and verapamil-nitroglycerin solution alone or in combination on the blood flow of radial artery.
Radial artery pedicle tissue cooling during harvesting is one of the major causes of vasospasm. We aimed to compare the effects of the pedicle rewarming method, normothermic organ bath, and one of the most preferred topical antispasmodic agents, verapamil-nitroglycerin solution alone or in combination on the blood flow of radial artery. ⋯ Hypothermia plays an important role in radial artery vasospasm. Normothermic organ bath and verapamil-nitroglycerin solution alone or in combination relieve spasm of radial artery.
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Eur J Cardiothorac Surg · Oct 2007
Randomized Controlled TrialEfficacy and safety of perioperative infusion of levosimendan in patients with compromised cardiac function undergoing open-heart surgery: importance of early use.
Levosimendan is a promising new inotrope. We investigate the proper time for its infusion during or after open-heart surgery to avoid complications related with low-output syndrome and high dosage of inotropes. ⋯ Levosimendan is a safe and efficient choice in the management of low-output syndrome during and after open-heart surgery. The shortening of hospitalisation and the trend for better outcome confirm its clear superiority when the infusion starts from the operating theatre.
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Eur J Cardiothorac Surg · Oct 2007
Case ReportsTracheoesophageal fistula and tracheo-subclavian artery fistula after tracheostomy.
Tracheoesophageal fistula and tracheo-arterial fistula are both uncommon but life-threatening complications after a tracheostomy. The most common source of a major hemorrhage is from the tracheo-innominate artery fistula. Most tracheo-arterial fistulas occur within the first 3 weeks after tracheostomy. We describe a very rare case of a patient who developed both a tracheoesophageal fistula and massive hemorrhage from a tracheo-left subclavian artery fistula 4 months after a tracheostomy procedure.
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Eur J Cardiothorac Surg · Oct 2007
The impact of symptom severity on cardiac reoperative risk: early referral and reoperation is warranted.
Operative mortality is comparatively higher for coronary artery bypass grafting (CABG) or valve reoperations. Studies of reoperative risk have focussed on surgical techniques. We sought to determine the risk and predictors of poor outcome in current practice, and the influence of preoperative symptoms. ⋯ In the current era, redo CABG is nearly as safe as the primary operation. A valve reoperation, on the contrary, is higher risk due, partly, to severe symptoms at presentation. Patients should be referred and operated on early before they develop severe symptoms.