Journal of cardiac surgery
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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.
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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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Case Reports
Echocardiographic diagnosis and surgical closure of coronary sinus type of atrial septal defect.
Coronary sinus type of atrial septal defect (ASD CS) is a rare cardiac anomaly and is rarely diagnosed by only transthoracic echocardiography prior to surgical operation. We now describe a technique to treat this defect with the aid of two-dimensional echocardiography, which prevents trauma to the conduction system and maintains drainage from the coronary sinus into the right atrium (RA).