European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Hemodynamic abnormalities and refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with Fontan conversion and concomitant arrhythmia surgery. ⋯ Fontan conversion with concomitant arrhythmia surgery and permanent pacemaker placement is safe, improves New York Heart Association functional class, and has a low incidence of recurrent arrhythmias. In most patients, concomitant permanent pacemakers are needed.
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To determine the optimum management of anastomotic leaks after oesophagectomy. ⋯ Diagnosis of anastomotic leakage after oesophagectomy is difficult due to its variable presentation and the unreliability of contrast swallow. Gastric tip necrosis is by far the most common cause. We feel our preferred strategy of immediate surgical treatment of symptomatic leaks is justified by the favourable outcome in the majority of patients.
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Eur J Cardiothorac Surg · Feb 2005
Anatomical variations of rami communicantes in the upper thoracic sympathetic trunk.
The aim of this study was to clearly delineate the anatomical variations of the communicating rami in the upper thoracic sympathetic nervous system and to help develop better surgical method for essential palmar hyperhidrosis. ⋯ On the basis of this study, the anatomical variations of communicating rami could explain some surgical failures and recurrences. Moreover, in addition to the conventional surgical methods (sympathectomy, sympathicotomy, clipping of sympathetic chain and ramicotomy), dividing the inconstant sympathetic pathways (nerve of Kuntz, ascending or descending rami communicantes) on the second, the third and the fourth ribs will help to get better surgical effect.
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Eur J Cardiothorac Surg · Feb 2005
Poly(ADP-ribose) polymerase inhibition attenuates biventricular reperfusion injury after orthotopic heart transplantation.
Poly (ADP-ribose) polymerase (PARP) activation plays a key role in free radical induced injury in ischemia/reperfusion. We investigated the effects of INO-1001 a novel PARP inhibitor on postischemic myocardial and endothelial function. ⋯ PARP inhibition reduces myocardial and endothelial reperfusion injury after orthotopic heart transplantation.
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Eur J Cardiothorac Surg · Feb 2005
Randomized Controlled Trial Clinical TrialDobutamine improves thoracic aortic blood flow during off-pump coronary artery bypass surgery: results of a prospective randomised controlled trial.
Dobutamine is commonly used to improve ventricular performance in cardiac surgery. The aim of this prospective randomised controlled study was to assess the effectiveness of using low doses of dobutamine during off-pump coronary artery bypass (OPCAB) surgery in order to reduce haemodynamic compromise due to heart displacement. ⋯ This study showed that intra-operative intravenous infusion of dobutamine at 5 microg/kg per min in routine OPCAB patients safely increased cardiac output even without such changes been detected by conventional monitoring methods.