European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 1997
Reoperations for bleeding after coronary artery bypass procedures during 25 years.
To study the incidence, causes and risk factors of reoperation for bleeding, 8563 coronary artery bypass procedures performed during 1970-1994 were reviewed. ⋯ Special precautions seem indicated to reduce the risk of reoperation for bleeding in particularly elderly patients undergoing combined coronary surgery and other intracardiac repair.
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Operative control via a thoracic approach of chylothorax can be difficult to achieve, particularly if the chyle leak is secondary to previous thoracic surgery. This report describes the ligation of the thoracic duct at the level of the diaphragmatic hiatus, via an abdominal approach. This technique was the definitive management in four of the last 5 patients presenting with chylothorax in our unit. Typically the leak ceased within 24 h with early discharge of the patient from hospital.
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Eur J Cardiothorac Surg · Feb 1997
Randomized Controlled Trial Multicenter Study Clinical TrialDuraflo II coating of cardiopulmonary bypass circuits reduces complement activation, but does not affect the release of granulocyte enzymes : a European multicentre study.
This study was carried out to: (a) compare complement and granulocyte activation during cardiac operations in patients operated with cardiopulmonary bypass coated with heparin by the Duraflo II method, with activation in patients operated with uncoated circuits; and (b) relate complement, and granulocyte activation to selected adverse effects. ⋯ It is concluded that the Duraflo II heparin coating reduces complement activation, particularly TCC formation, during CPB, but not the release of specific neutrophil granule enzymes. No certain correlation was established between complement and granulocyte activation and clinical outcome.
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Eur J Cardiothorac Surg · Feb 1997
Randomized Controlled Trial Comparative Study Clinical TrialEEG changes during cardiopulmonary bypass surgery and postoperative neuropsychological deficit: the effect of bubble and membrane oxygenators.
Quantitative electroencephalography was used during cardiopulmonary bypass surgery to determine the point in time of most neuronal functional change which may result in postoperative neuropsychological deficit. It was also used to determine any relationship between quantitative electroencephalography changes and type of oxygenator used in surgery. ⋯ While no difference in anaesthetic technique was found between patients, the variation in quantitative electroencephalography power before perfusion may indicate a difference in individual response to anaesthetic. Usefulness of quantitative electroencephalography to predict postoperative cerebral functional deficit remains doubtful.
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Eur J Cardiothorac Surg · Feb 1997
Comparative StudySurgical treatment for life-threatening acute myocardial infarction: a prospective protocol.
In this paper we describe the preliminary results of a prospective operative protocol designed in order to define the role of emergent myocardial revascularization in extensive acute myocardial infarction and in post-infarction cardiogenic shock. ⋯ Experience of 9 months with this prospective protocol showed its effectiveness in the management of critically ill patients with acute coronary occlusion leading to low mortality rate in acute myocardial infarction and improved survival rate in post-infarction cardiogenic shock.