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 2003
Randomized Controlled Trial Clinical TrialDopexamine increases internal mammary artery blood flow following coronary artery bypass grafting.
Vasoactive agents and inotropes influence conduit-coronary blood flow following coronary artery bypass grafting (CABG). It was hypothesized that dopexamine hydrochloride, a dopamine A-1 (DA-1) and beta(2) agonist would increase conduit-coronary blood flow. A prospective randomized double blind clinical trial was carried out to test this hypothesis. DA-1 receptors have previously been localized to human left ventricle. ⋯ This study demonstrates that administration of dopexamine (1 microg/kg per min) was associated with a significant increase in internal mammary artery graft blood flow with mild increase in heart rate being the only haemodynamic change. Low-dose dopexamine may improve graft flow in the early post CABG period with minimal haemodynamic changes.
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Eur J Cardiothorac Surg · Oct 2003
Postoperative pain detracts from early health status improvement seen after video-assisted thoracoscopic lung volume reduction surgery.
To assess the impact of lung volume reduction surgery (LVRS) on postoperative pain. ⋯ Postoperative pain detracts from global improvement in health status after LVRS even after unilateral VATS. There may be an influence of alterations in chest mechanics after surgery on the development of pain.
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Eur J Cardiothorac Surg · Oct 2003
Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma.
Rib fractures are the most common injuries resulting from blunt chest trauma. The sensitivity of chest X-rays in showing the rib fractures is limited particularly in those involving the cartilage part of the rib. We investigated the possible rib fractures, those overlooked on chest X-rays, with the use of ultrasonography in minor blunt chest trauma. ⋯ Ultrasonography is a useful imaging method in showing the rib fractures those overlooked on chest X-rays in minor blunt chest trauma, and no significant clinical feature exists as a predictor for these insidious fractures. However, bony rib fractures significantly occur in elderly patients and result in a longer duration of pain.
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Eur J Cardiothorac Surg · Oct 2003
Case ReportsEmergent pulmonary thromboendarterectomy with percutaneous cardiopulmonary support system for chronic thromboembolic pulmonary hypertension.
Pulmonary thromboendarterectomy offers a comparatively low surgical mortality rate with appropriate patient selection. However, the operative mortality in patients with high pulmonary vascular resistance or severe pulmonary hypertension and subsequent right ventricular failure is poor. We report an unusual case that survived an emergent pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension with right ventricular failure.