Journal of cardiac surgery
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Review Meta Analysis Comparative Study
Intravenous magnesium for prevention of atrial fibrillation after coronary artery bypass surgery: a systematic review and meta-analysis.
Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass surgery. The objective of this study was to assess the effectiveness of intravenous magnesium in preventing postoperative atrial fibrillation. ⋯ The primary outcome was incidence of postoperative atrial fibrillation. Our review revealed that use of intravenous magnesium is associated with a significant reduction in the incidence of atrial fibrillation after coronary artery bypass surgery, with a relative risk of 0.64 (95% confidence interval = 0.47, 0.87, and p = 0.004).
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Randomized Controlled Trial Comparative Study Clinical Trial
The reinforced sternal closure system is reliable to use in elderly patients.
Sternal dehiscence is a rare, but serious complication after cardiac surgery procedures when performed through mid-line sternotomy. Osteoporosis, especially at advanced age, may be a significant factor in the unfavorable results of sternum fixation. The present prospective, randomized study was carried out to evaluate whether the reinforced sternal-closure system is an effective and safe fixation and approximation of the sternum in cardiac procedures, and to compare with the conventional sternal-closure method in elderly patients. ⋯ The reinforced sternal-closure system provided no additional risk with similar postoperative pain index and postoperative hospital stay compared with conventional method. It is reliable to use in elderly patients undergoing open heart surgery, in the cases presenting a risk factor such as osteoporosis for increased incidence of sternal dehiscence.
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The aim of this study is to investigate the effects of ischemic preconditioning (IP) on myocardium and the level of nitric oxide (NO) in patients undergoing aorta-coronary bypass surgery. ⋯ These data may suggest that cardioprotection by ischemic preconditioning offers higher NO production, a lower myocardial ischemia, and better functional recovery of the hearts in coronary artery surgery patients.
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Comparative Study
Survival and quality of life after cardiac surgery complicated by prolonged intensive care.
To determine survival, factors determining survival and evaluate quality of life (QOL) after 1 year, in patients who had prolonged intensive care unit (ICU) stay after cardiac surgery. ⋯ One year mortality in patients with prolonged ICU stay after cardiac surgery remains high. Identification of risk factors will help to reduce the mortality with help of regular follow up. The QOL remains low in all dimensions especially those measuring physical aspects and pain.
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Erythropoietic protoporphyria (EPP) is an autosomal dominant disorder of heme synthesis, causing excess of protoporphyrin in blood, skin, liver, and other organs. A 58-year-old male patient with EPP underwent aortic valve replacement and a concomitant aortocoronary bypass. The patient has been followed without complications due to EPP postoperatively. Cardiac surgery can safely be performed on patients with EPP by considering close attention not to stimulate porphyrin synthesis.