Journal of cardiac surgery
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Both coronavirus disease (COVID-19) and cardiac surgery have a negative impact on pulmonary function. This study aimed to determine the postoperative respiratory outcomes of patients with COVID-19 who underwent cardiac surgery. ⋯ Although early respiratory outcomes of asymptomatic COVID-19 patients who underwent early cardiac surgery appeared to be satisfactory, compared to the propensity-scored matched non-COVID group, the postoperative outcomes were worse, especially in the ICU readmitted patients. We suggest postponing cardiac operations unless the patient requires emergency surgery.
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Case Reports
Successful treatment of thoracic aortic graft infection by omental flap following vacuum-assisted closure therapy.
Postoperative thoracic aortic graft infection (TAGI) is a serious and potentially fatal complication. The classical approach is to replace the infected graft. However, this approach has a high mortality rate. Alternatively, treatment of TAGI without graft replacement can be performed METHOD: Herein, we present a 72-year-old case with mediastinitis and graft infection after type A aortic dissection operation and successful treatment using omental flap coverage following vacuum-assisted wound closure therapy without graft replacement. ⋯ The patient had an uneventful postoperative course and remains infection-free to date.
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We aimed to examine the literature evidence behind using extracorporeal membrane oxygenation in COVID-19 patients in a systematic review manner. ⋯ Our study highlights the paucity of evidence and the need for further data to consolidate the efficacy of ECMO in improving patient outcomes. Although ECMO has been shown to be beneficial in a selected group of patients, the recuperative effects of ECMO remain inconclusive. We must ensure that risk-benefit analysis for each candidate is conducted thoroughly so that patients that have increased probability of survival can benefit from this scarce resource.
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Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is utilized as a life-saving procedure and bridge to myocardial recovery for patients in refractory cardiogenic shock. Despite technical advancements, VA-ECMO retains high mortality. This study aims to identify the clinical predictors of in-hospital mortality after VA-ECMO to improve risk stratification for this tenuous patient population. ⋯ In a large study of recent VA-ECMO patients, in-hospital mortality remains significant, but acceptable given the severe pathology manifested in this population. Identification of pre-ECMO predictors of mortality helps stratify high-risk patients when deciding on ECMO placement, prolonged support, and prognosis.