Journal of cardiac surgery
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Important studies highlighting the practice of coronary artery bypass surgery for 2011 are reviewed.
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Extubation in the operating room (OR) after cardiac surgery is hampered by safety concerns, psychological reluctance, and uncertain economic benefit. We have studied the factors affecting the feasibility of extubation in the OR after cardiac surgery and its safety. ⋯ Extubation in the OR can be safely performed in a select group of cardiac surgery patients without any increase in postoperative morbidity or mortality. The proposed mathematical model performed reasonably well in predicting a successful extubation in the OR.
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This retrospective study evaluated factors associated with mortality and morbidity in patients having functionally biventricular heart (FBH) and functionally univentricular heart (FUH) undergoing total anomalous pulmonary venous connection (TAPVC) repair. ⋯ Operative results of TAPVC have dramatically improved in recent years. However, patients having FUH (especially with concomitant palliative surgery), heterotaxy syndrome, low weight, early age, and long CPB time still have an increased operative mortality.
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Case Reports
Gerbode defect with Staphylococcus lugdunensis native tricuspid valve infective endocarditis.
Coagulase-negative staphylococci are generally not considered to be very virulent; they are an uncommon cause of native valve endocarditis. Staphylococcus lugdunensis is an important exception and causes more severe infections, clinically mimicking S. aureus. We present a case of direct Gerbode defect associated with S. lugdunensis native valve infective endocarditis (IE) requiring cardiac surgery.
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Anomalies of the pulmonary venous drainage vary widely in their anatomic spectrum and clinical presentation. We describe an unusual case of supra-cardiac total anomalous pulmonary venous connection (TAPVC), where the pulmonary veins drained directly in the posterior aspect of proximal right superior vena cava (SVC) through separate ostia. The veins were re-routed with a patch to the left atrium via the secundum atrial septal defect (ASD). The continuity between distal SVC and right atrium was re-established by re-implanting the SVC to the right atrial appendage (Warden Procedure).