European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 1998
Randomized Controlled Trial Clinical TrialThe effect of angiotensin converting enzyme inhibition on myocardial function and blood pressure after coronary artery bypass surgery--a randomised study.
To investigate the effect of 6 weeks' pre-operative treatment with the angiotensin converting enzyme inhibitor, quinapril, on left ventricular function when measured 3 months after coronary artery bypass graft surgery and to examine the safety of such treatment. ⋯ Angiotensin converting enzyme inhibitor treatment before coronary artery bypass graft surgery does not have a significant beneficial effect on left ventricular function following coronary artery bypass graft surgery. Angiotensin converting enzyme inhibition, administered in addition to anti-anginal therapy, does not cause first-dose hypotension or increase morbidity or mortality and can safely be used in patients with coronary heart disease prior to coronary artery bypass graft surgery.
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Eur J Cardiothorac Surg · Dec 1997
Case Reports Comparative StudyCritical illness polyneuropathy: a new iatrogenically induced syndrome after cardiac surgery?
Critical illness polyneuropathy (CIP) is a newly described severe complication after open heart surgery leading to tetraplegia for weeks to months. The purpose of the study was to gather further information on critical illness polyneuropathy developing in patients after cardiac surgery and to evaluate the hypothetical risk factors possibly related to the onset of this neurological disorder. ⋯ CIP, despite it's benign nature due to it's spontaneous remission in patients who survive, is a disturbing complication following cardiac surgery which is associated with high mortality, a prolonged stay in the ICU, as well as an extended time on ventilator support. Interventions like chronic hemodiafiltration, the application of corticosteroids and the administration of high doses of catecholamines are more frequent in patients with CIP. Whether this indicates a causal relationship remains to be elucidated.
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Eur J Cardiothorac Surg · Dec 1997
Case ReportsProgressive dysphonia and acute respiratory failure: revealing a bronchogenic cyst.
We report the case of a 17-year old girl presenting a 3-month history of progressive dysphonia, and ultimately acute respiratory failure. CT scan and bronchoscopy showed severe extrinsic compression of the carina and of the left main stem bronchus. ⋯ The post operative course was uneventful except a persistent dysphonia. Dysphonia is an exceptional early symptom of bronchogenic cyst located in the oesophageal wall.
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Eur J Cardiothorac Surg · Nov 1997
Comparative Study Clinical Trial Controlled Clinical TrialIschemic preconditioning prior to myocardial protection with cold blood cardioplegia in coronary surgery.
Encouraging results on myocardial preconditioning in experimental models of infarction, stunning or prolonged ischemia raise the question whether preconditioning techniques may enhance conventional cardioplegic protection used for routine coronary surgery. ⋯ Combining ischemic preconditioning and cardioplegic protection with cold blood cardioplegia does not appear to ameliorate myocardial protection when compared to cardioplegic protection applying cold blood cardioplegia alone. Inversely, contractile function seemed to be impaired when applying this protocol of ischemic preconditioning.
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Eur J Cardiothorac Surg · Nov 1997
Comparative Study Clinical TrialEvaluation of routine postoperative chest X-rays in the management of the cardiac surgical patient.
To evaluate the role of routine chest X-rays in the management of patients post cardiac surgery. ⋯ Routine chest X-rays post-cardiac surgery are of very little value and patients are adequately managed by performing chest X-rays only when clinically indicated. There was no increased mortality or morbidity attributed to lack of routine chest X-rays in any of these groups. We recommend performing chest X-rays only when clinically indicated in satisfactorily recovering adult cardiac surgical patients.