European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2004
Comparative StudyStudy on the late effect of pneumonectomy on right heart pressures using Doppler echocardiography.
Changes in the pulmonary artery systolic pressure (PASP) and the dimensions of the right ventricle (RV) of the heart, six months after pneumonectomy, were evaluated in order to detect the influence of pneumonectomy on right heart function. ⋯ Pneumonectomy is related with postoperative elevation of PASP and RV dilatation, especially right pneumonectomy. Significant percent FVC reduction, increased age and low pO2 values are the main responsible factors for elevation of the 6-month postoperative PASP values.
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Eur J Cardiothorac Surg · Sep 2004
Comparative StudyOperative mortality after conventional versus coronary revascularization without cardiopulmonary bypass.
Off-pump coronary artery bypass (CABG) is a safe revascularization option with comparable or superior results to the conventional on-pump CABG. However, comparative analysis of the type of surgical approach on the mortality rate is largely unknown. This study sought to investigate whether CABG without cardiopulmonary bypass (off-pump CABG) is associated with lower operative mortality than the conventional on-cardiopulmonary bypass (on-pump) approach. ⋯ Excellent clinical results and a lower operative mortality rate can be achieved with the off-pump CABG technique compared with the conventional on-pump approach.
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Eur J Cardiothorac Surg · Sep 2004
Cardiac output monitoring by pressure recording analytical method in cardiac surgery.
A less-invasive method has been developed that may provide an alternative to monitor cardiac output from arterial pressure: beat-to-beat values of cardiac output can be obtained by pressure recording analytical method (PRAM). The purpose of this study was to assess the reliability of cardiac output determination by PRAM in cardiac surgery. ⋯ Under the studied conditions, our results demonstrate good agreement between PRAM data and ThD measurements, and this new method has shown to be accurate for real-time monitoring of cardiac output in cardiac surgery. Further studies will be required to assess this method in higher-risk patients and in the setting of haemodynamic instability or arrhythmias. This is the first study designed to assess the accuracy of PRAM in cardiac surgery.
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Eur J Cardiothorac Surg · Sep 2004
Perioperative myocardial infarction has negative impact on health-related quality of life following coronary artery bypass graft surgery.
Perioperative myocardial infarction (PMI) is a well-described complication of coronary artery bypass grafting (CABG). Data on its effect on patients' subsequent health-related quality of life (QOL) and on other related consequences is deficient. The aim here was to evaluate in a prospective follow-up design the risk factors for and consequences of PMI and especially its possible impact on health-related QOL. ⋯ PMI increases 30-day mortality and affects also adversely on later health-related QOL following CABG.
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Eur J Cardiothorac Surg · Sep 2004
Comparative StudyVentilation prevents pulmonary endothelial dysfunction and improves oxygenation after cardiopulmonary bypass without aortic cross-clamping.
Endothelial dysfunction of the pulmonary arterial tree occurring after cardiopulmonary bypass (CPB) contributes to pulmonary hypertension and respiratory failure in the postoperative period. The goal of the present study was to characterize the alterations of endothelial cell signal transduction pathways in pulmonary arteries following CPB, the effect of ventilation and nitric oxide (NO) inhalation on endothelium-dependent relaxations and the alterations in hemodynamics and oxygenation. ⋯ Pulmonary reperfusion after CPB causes a selective dysfunction of Gi-protein-mediated relaxations. Mechanical ventilation prevents the pulmonary endothelial dysfunction due to reperfusion after CPB. Ventilation also improves oxygenation after CPB. Mechanical ventilation could be used as a preventive approach for patients undergoing cardiac surgery with extracorporeal circulation.