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 1999
Comparative StudySaphenous neuralgia after coronary artery bypass grafting.
To determine the incidence, extent and site of saphenous neuralgia (anaesthesia, hyperaesthesia and pain) in the lower limb after harvesting of great saphenous vein (GSV) for coronary artery bypass grafting (CABG). ⋯ This study demonstrates that saphenous neuralgia after harvest of GSV for CABG is common. The main symptom is anaesthesia and certain areas may persist for some considerable time post-operatively.
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Eur J Cardiothorac Surg · Oct 1999
Comparative StudyProspective evaluation of coronary arteries: influence on operative risk in coronary artery surgery.
Coronary angiography data included in the analysis of operative mortality after coronary artery surgery are generally limited to left main coronary artery stenosis and classification into one-, two- or three-vessel disease, but the role of stenoses and quality of distal runoff on each main coronary artery have never been analysed. The aim of this study was to assess the influence of coronary artery status (stenoses and distal runoff) on operative mortality in patients undergoing coronary artery surgery. ⋯ The quality of distal runoff of the most frequently grafted vessels is a significant risk factor for operative mortality in coronary artery surgery. Left main coronary artery stenosis was not identified as a risk factor when these angiographic variables were included in the analysis. Functional status remains the most powerful predictive factor.
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Eur J Cardiothorac Surg · Oct 1999
Comparative StudyRoutine SvO2 measurement after CABG surgery with a surgically introduced pulmonary artery catheter.
It has been argued that the poor correlation between cardiac output and mixed venous oxygen saturation (SvO2) reduces the value of SvO2. Routine use of Swan Ganz catheters is also controversial in cardiac surgery. Here our clinical experience with a simplified method for routine hemodynamic monitoring and the short-term prognostic value of SvO2 after CABG surgery is presented. ⋯ SvO2 was of prognostic value and due to its specificity it seems particularly useful for telling which patients are unlikely to develop cardiorespiratory problems. Thus, this simple method for hemodynamic monitoring could contribute to cost containment as it seems that we can safely reserve Swan Ganz catheters for high-risk patients.
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Eur J Cardiothorac Surg · Sep 1999
Comparative Study Clinical Trial Controlled Clinical TrialEarly and long-term results of surgery for aneurysms of the thoracic aorta in septuagenarians and octogenarians.
The purpose of this study was to demonstrate early and long-term results of surgery for thoracic aortic aneurysm in patients over 70 years of age compared with those of patients under 70 years and to clarify the clinical problems peculiar to this subset of patients. ⋯ Although recent advances have been achieved, early and long-term results of surgery for thoracic aortic aneurysm in patients older than 70 years were less satisfactory compared with those of patients under 70 years of age, especially in patients who required emergency surgery. Preoperative disorder of the vital organ systems was considered to be the main causative factor for high mortality, however, pertinent surgical strategies are necessary to improve the outcome of elderly patients.
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Eur J Cardiothorac Surg · Sep 1999
Comparative Study Clinical TrialThe effects of cardioplegia on coronary pressure-flow velocity relationships during aortic valve replacement.
The acute physiological response of the coronary circulation to aortic valve replacement (AVR) has not been fully elucidated. This study aimed to characterize the changes in coronary perfusion pressure-flow velocity relationships, and to test whether this relationship is affected by cardioplegic method. ⋯ Instantaneous diastolic LAD pressure-flow velocity relations in the early postoperative period can be explained more satisfactorily in terms of zero flow pressure and proximal linear resistance than simple resistance alone. The fall in zero flow pressure alone explains the increase in LAD flow velocity immediately after aortic valve replacement. The extent of this fall is greater after warm rather than cold blood cardioplegia.