Journal of cardiac surgery
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Multicenter Study Comparative Study
Postoperative inotrope and vasopressor use following CABG: outcome data from the CAPS-care study.
Limited clinical data exist to guide practice patterns and evidence-based use of inotropes and vasopressors following coronary artery bypass grafting (CABG). ⋯ While considerable variability is present among hospitals in inotrope use following CABG, observational comparison of outcomes did not distinguish a superior pattern; thus, randomized prospective data are needed to better guide clinical practice.
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A 60-year-old femalepresented with progressive dysphagia and was found to have a right-sided aortic arch with external posterior compression of the upper esophagus due to severe compression from a Kommerell's diverticulum with an aberrant left subclavian artery. This patient underwent division of the diverticulum with an aorto-subclavian graft implantation under femoro-femoral bypass and recovered uneventfully. A review of the literature and discussion of the surgical management is presented.
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Comparative Study
Left internal thoracic artery composite grafting with the right internal thoracic versus radial artery in coronary artery bypass grafting.
The aim of this study was to compare the results of all arterial multivessel coronary artery bypass grafting using the left internal thoracic artery composite bypass graft constructed with the right internal thoracic artery or radial artery. ⋯ Although superior patency was observed with the right internal thoracic artery over the radial artery graft, a significant commensurate benefit in reducing the incidence of major adverse clinical outcomes was not necessarily shown.
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Case Reports
Impella LP 2.5 for left ventricular unloading during venoarterial extracorporeal membrane oxygenation support.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is commonly used as a means of support for acute cardiopulmonary failure. In the setting of severe left ventricular (LV) dysfunction, VA-ECMO may be complicated by LV distension, which can lead to pulmonary edema and compromise myocardial recovery. ⋯ We report the use of the Impella LP 2.5 for LV decompression in a 70-year-old man with decompensated heart failure who was placed on VA-ECMO for cardiogenic shock with severe pulmonary edema and respiratory failure. Both devices were successfully weaned on day 5 of VA-ECMO support, after myocardial recovery.
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Comparative Study
Midterm outcomes of off-pump and on-pump coronary artery revascularization in renal transplant recipients.
Renal transplant recipients have high mortality from cardiac causes and are frequently in need of coronary interventions. Surgical coronary revascularization is associated with significant morbidity and mortality in this patient population. This study was undertaken to evaluate outcomes of on-pump versus off-pump revascularization in renal transplant recipients. ⋯ Despite higher mortality risk, surgical coronary revascularization can be performed safely in renal transplant recipients. OPCAB resulted in no improvement in patient survival or renal allograft function compared to on-pump revascularization.