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 2002
Case ReportsIatrogenic left main and proximal right coronary artery stenoses after aortic valve replacement.
Iatrogenic left main coronary artery stenosis after aortic valve replacement is an infrequent but potentially life-threatening complication. A 44-year-old woman who had normal coronary arteries documented by preoperative coronary angiogram, and who developed severe stenosis of the left main coronary artery and subtotal occlusion of the proximal right coronary artery after aortic and mitral valve replacements is presented. ⋯ Accurate diagnosis was confirmed by repeat coronary angiography. She underwent successful coronary artery bypass grafting.
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Eur J Cardiothorac Surg · Aug 2002
The effect off-pump coronary artery bypass surgery on in-hospital mortality and morbidity.
Off-pump coronary artery bypass (OPCAB) surgery is being increasingly reported to show better outcomes compared to conventional on bypass grafting. We examined the effect of OPCAB on in-hospital mortality and morbidity, while adjusting for patient and disease characteristics, in four institutions in the North West of England. ⋯ Off-pump coronary artery bypass incurs no increased risk of in-hospital mortality. In contrast, there is a significant reduction in morbidity in patients undergoing off-pump coronary bypass grafting when compared to that performed on cardiopulmonary bypass.
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We present a patient who was referred to our thoracic surgical service with a massive, loculated right pleural effusion accompanied by significant ascites. Thoracotomy and decortication were required and pleural biopsy led to a diagnosis of endometriosis. ⋯ There are less than 15 reported cases of endometriosis presenting with both pleural effusion and ascites. Thoracic surgeons presented with such a scenario should be cognizant of this pathological entity.
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Eur J Cardiothorac Surg · Aug 2002
A case-control analysis of readmissions to the cardiac surgical intensive care unit.
To identify predictors of requirement for readmission to the intensive care unit (ICU) for patients undergoing cardiac surgery. ⋯ Readmission of cardiac surgical patients to the ICU is associated with high morbidity and mortality, and substantial resource consumption. Parsonnet or EuroSCORE risk stratification models in combination with obesity, operative urgency, resternotomy and respiratory indices at time of intended ICU discharge are strongly associated with readmission to ICU.
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Eur J Cardiothorac Surg · Aug 2002
Randomized Controlled Trial Clinical TrialSignificant merits of a fibrin sealant in the presence of coagulopathy following paediatric cardiac surgery: randomised controlled trial.
The efficacy of a fibrin sealant in paediatric cardiac surgery has been demonstrated. However, its effectiveness in the presence of significant untreated coagulopathy has not been addressed. This study was designed to investigate the role of the topical application of a fibrin sealant, Beriplast P (BP), in the presence of coagulopathy following paediatric cardiac surgery. ⋯ Even in the presence of significant coagulopathy, intraoperative use of fibrin sealant in paediatric cardiac surgery reduces the amount of bleeding and need for transfusions of blood and blood products. The theatre time necessary to achieve haemostasis is also significantly reduced. These findings have a potential to improve clinical outcomes and enhance cost benefits.