European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Jul 2005
Comparative StudyThe sealing effect of fibrin glue against alveolar air leakage evaluated up to 48 h; comparison between different methods of application.
There is little experimental evidence to show how much positive airway pressure fibrin sealants can actually withstand, and in particular, how this effect changes over time. In the present study, we experimentally evaluated the sealing effect of fibrin glue against alveolar air leakage up to 48 h after application. ⋯ The results show that the sealing effect of fibrin glue is relatively unstable up to 12h after its application. Rubbing and spray method may help the fibrin seal to reach its full strength faster compared with the other two methods.
-
Eur J Cardiothorac Surg · Jul 2005
Homograft reconstruction of the aortic root for endocarditis with periannular abscess: a 17-year study.
The study was conducted to evaluate the long-term results of homograft reconstruction of the left ventricular outflow tract with a cryopreserved aortic homograft in the presence of aortic root abscess associated with a biofilm bacterial infection. ⋯ Radical debridement of the infected aortic root and homograft ARR offer a low recurrent infection rate and an overall low valve-related morbidity and mortality for up to 17 years. The antibiotic permeable cryopreserved homograft has proven to be resistant to biofilm bacterial infection.
-
Eur J Cardiothorac Surg · Jun 2005
Randomized Controlled Trial Comparative Study Clinical TrialClinical experience with the Novare Enclose II manual proximal anastomotic device during off-pump coronary artery surgery.
The aim of this study was to assess the feasibility and safety of a new proximal anastomotic device during off-pump coronary surgery. ⋯ The Enclose II device can be a valuable tool to perform venous or arterial proximal anastomoses during off-pump CABG. Transcranial Doppler results suggest that the device seems to be less traumatizing than side clamping and may reduce clamp-associated complications during off-pump coronary artery surgery.
-
Eur J Cardiothorac Surg · Jun 2005
Multicenter StudyCumulative risk adjusted monitoring of 30-day mortality after cardiothoracic transplantation: UK experience.
Guidelines are needed for real-time quality monitoring in heart and lung transplantation. The cumulative sum (CUSUM) methodology with boundary limits derived from the sequential probability ratio test (SPRT) provide a means of monitoring performance without the need for repeated statistical testing. The variable life adjusted display (VLAD) complements the SPRT chart and provides a directly interpretable assessment of performance. We present our experience with these charts in monitoring cardiothoracic transplant outcomes in the UK. ⋯ CUSUM charts are useful tools for monitoring performance, and provide a basis for visually comparing results between centres and identifying periods of 'bad runs'. Risk-adjustment, which down-weights higher risk activity, avoids inappropriate reaction to unadjusted breaches of alert and alarm lines.
-
Eur J Cardiothorac Surg · Jun 2005
Comparative StudyComparison of hemodynamics between Norwood procedure and systemic-to-pulmonary artery shunt for single right ventricle patients.
Despite that surgical outcomes of patients with hypoplastic left heart syndrome have improved, one of the problems remaining is the high interstage mortality after a stage I Norwood procedure. The purpose of this study was to determine the hemodynamic characteristics of hypoplastic left heart syndrome after a Norwood procedure. We examined the perioperative hemodynamic differences of the staged operation between the first stage of the Norwood procedure and systemic pulmonary shunt for single right ventricle patients. ⋯ Patients with hypoplastic left heart syndrome showed hemodynamic instability of acutely increased cardiothoracic ratio, and single ventricular diastolic dimension despite decreased oxygen saturation interstage after stage I of a Norwood procedure. This suggests that this hemodynamic characteristics in hypoplastic left heart syndrome correlates with the higher mortality before second stage palliation than in found with single right ventricle patients.