European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 1999
Cytokine and S100B levels in paediatric patients undergoing corrective cardiac surgery with or without total circulatory arrest.
Neurological damage following cardiopulmonary bypass (CPB) is difficult to objectively evaluate in infants. In adults, serum elevations of astroglial S100B correlate with proven brain injury independent of operative temperature. The deleterious effects of inflammatory cytokines, generated during CPB, on the brain have not been studied in infants using S100B as a marker for cerebral injury. ⋯ (1) The TCA group have prolonged rises of IL-6, IL-8 and S100B. (2) The TCA group generates significantly lower complement. (3) Astroglial injury, seen after surgery, may, in part, be cytokine mediated.
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Eur J Cardiothorac Surg · Jun 1999
Comparative StudyEvaluation of coronary bypass flow with color-Doppler and magnetic resonance imaging techniques: comparison with intraoperative flow measurements.
After coronary artery bypass surgery, patency and flow assessment is based on invasive methods such as angiography and intravascular ultrasound or flow wire techniques. The aim of the study was to compare intraoperative transit time flow measurements of coronary bypass grafts with early postoperative color-Doppler and MR-imaging assessment. ⋯ The color-Doppler method during echocardiography and MR-imaging are useful non-invasive techniques to visualize postoperative IMA grafts for patency assessment. The quantification of IMA flow is still difficult with either technique, but MR flow measurements showed the best correlation to the intraoperatively measured transit time flow. The MR technique is the most promising non-invasive method for postoperative evaluation of coronary bypass grafts, since it allows visualization and reliable flow quantification.
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Eur J Cardiothorac Surg · Jun 1999
Multicenter StudyRisk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients.
To assess risk factors for mortality in cardiac surgical adult patients as part of a study to develop a European System for Cardiac Operative Risk Evaluation (EuroSCORE). ⋯ A number of risk factors contribute to cardiac surgical mortality in Europe. This information can be used to develop a risk stratification system for the prediction of hospital mortality and the assessment of quality of care.
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Eur J Cardiothorac Surg · Jun 1999
Randomized Controlled Trial Clinical TrialAutotransfusion of washed shed mediastinal fluid decreases the requirement for autologous blood transfusion following cardiac surgery: a prospective randomized trial.
The National Blood Service issues 2.2 million units of blood per year, 10% of these (220000) are utilized in cardiac procedures. Transfusion reactions, infection risk and cost should stimulate us to decrease this transfusion rate. We test the efficacy of autotransfusion following surgery in a prospective randomized trial. ⋯ Autotransfusion can decrease the amount of homologous blood transfused following cardiac surgery. This represents a benefit to the patient and a decrease in cost to the health service.
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Eur J Cardiothorac Surg · Jun 1999
Modified ultrafiltration improves global left ventricular systolic function after open-heart surgery in infants and children.
Modified ultrafiltration increases blood pressure and cardiac index following open-heart surgery in children, but it is unclear if this is secondary to an improvement in global left ventricular function. A previous report has suggested that left ventricular systolic function as assessed in a single chord is improved by ultrafiltration (Davies MJ, Nguyen K, Gaynor JW, Elliott MJ. Modified ultrafiltration improves left ventricular systolic function in infants after cardiopulmonary bypass. J Thorac Cardiovasc Surg 1998;115:361--370). The prominent vascular actions of modified ultrafiltration necessitate left ventricular assessment using load-independent indices of systolic and diastolic function. ⋯ Modified ultrafiltration improves global left ventricular systolic function in infants and children following open-heart surgery.