Journal of cardiac surgery
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The use of carbon dioxide (CO(2)) insufflation into the pericardial well has become widespread, and in some units routine. The rationale behind this practice is the fact that CO(2) is more soluble than air leading to fewer gaseous microemboli entering the bloodstream and being transferred to the brain or heart. ⋯ Although CO(2) insufflation is generally a safe procedure there are case reports of significant complications. The aim of this systematic review is to analyze the current evidence for this practice.
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Comparative Study
Strategies and outcomes of cardiac surgery in Jehovah's Witnesses.
Jehovah's Witnesses (JW) are a Christian faith, with an estimated 1.1 million members in the United States, well recognized for their refusal of blood and blood products. JW may not be considered for cardiac surgery due to perceived higher risks of morbidity and mortality. This study reviews our contemporary strategies and experience with JW undergoing routine and complex cardiac surgery. ⋯ Using a multidisciplinary approach to blood management, JW can safely undergo routine and complex cardiac surgery with minimal morbidity and mortality.
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We report our experience with a five-year-old child with d-transposition of great arteries (d-TGA), ventricular septal defect (VSD), and severe pulmonary arterial hypertension (PAH). A fenestrated unidirectional-valved patch was used to close the VSD and a standard arterial witch operation (ASO) was performed. Difficulties in assessment of operability and the choice of procedures in such patients are briefly discussed.
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Comparative Study
Assessment of EuroSCORE in patients undergoing aortic valve replacement.
The logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) is a risk stratification system used to predict the operative risk in patients undergoing surgical aortic valve replacement (AVR). The aim of this study is to investigate how accurate this system is, and how it compares to the observed risk. ⋯ The logistic EuroSCORE overestimates the risks for AVR. Therefore, it should not be used to deny high-risk patients a surgical AVR.
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Case Reports
Embolic occlusion of the left main coronary artery following an isolated aortic valve replacement.
Coronary occlusion after aortic valve replacement due to embolization is a rare complication. We report the case of a patient who developed acute heart failure due to occlusion of the left main coronary artery following an aortic valve replacement. Successful treatment was achieved with emergent coronary bypass surgery.