Journal of cardiac surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of timing of chest tube removal on development of pericardial effusion following cardiac surgery.
There are no standard criteria for the timing of drain removal. The objective of this study was to determine whether the macroscopic appearance of chest tube drainage fluid to serosanguineous may be used as a criteria for drain removal. ⋯ It is safe to remove the chest tubes as soon as the macroscopic appearance of the drainage fluid turns to serosanguineous since this practically indicates cessation of active bleeding.
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Comparative Study
Bilateral pectoral myocutaneous advancement flaps and anatomic sternal wound reconstruction in cyanotic infants with mediastinitis.
The purpose of this study was to assess the results and applicability of a modified chest closure technique employing bilateral pectoral myocutaneous advancement flaps after sternal re-approximation for postoperative mediastinitis in cyanotic infants. ⋯ For postcardiotomy mediastinitis in cyanotic infants we recommend limited debridement and anatomic sternal reconstruction supported by bilateral pectoral myocutaneous advancement flap closure.
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Comparative Study
Heparin-coated circuits (Duraflo II) with reduced versus full anticoagulation during coronary artery bypass surgery.
Introduction of completely heparin-coated cardiopulmonary bypass (CPB) circuits combined with reduced systemic anticoagulation has been shown to reduce postoperative bleeding and requirements for allogeneic transfusions after cardiac surgery. However, some uncertainty exists whether this effect is due to the reduced amount of heparin or to the heparinized surface itself. Therefore, a retrospective study was undertaken, comparing two different anticoagulation protocols applied to coronary artery bypass patients treated with identical heparin-coated CPB equipment. ⋯ The use of Duraflo II coated circuits for CPB combined with reduced anticoagulation decrease postoperative bleeding and hemoglobin loss compared with full heparin dose treatment. In addition, the intubation time was shorter and the incidence of postoperative atrial fibrillation was lower in the patients treated with low heparin doses.
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Randomized Controlled Trial Comparative Study Clinical Trial
Single aortic clamp versus partial occluding clamp technique for cerebral protection during coronary artery bypass: a randomized prospective trial.
Single aortic clamp (SAC) versus partial occluding clamp (POC) technique for the construction of proximal anastomosis has been suggested to provide better cerebral protection during coronary artery bypass grafting (CABG). The aim of this study was to assess this hypothesis in a prospective randomized trial. ⋯ The SAC technique improved cerebral protection without any adverse effect on myocardial protection and postoperative outcome in patients undergoing CABG.
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Comparative Study
Left ventricular assist devices as bridge to heart transplantation: The Niguarda Experience.
Congestive heart failure is the leading cause of death in Western countries. Heart transplantation currently is the only accepted therapy for patients with end-stage heart failure, but the supply of donor hearts is inadequate, and different mechanical circulatory support systems have been investigated as bridges to heart transplant. ⋯ LVAD therapy proved to be effective in bridging patients with end-stage heart failure to HTx. While on LVAD support, patients assisted with implantable wearable devices could be discharged at home, ameliorating their quality of life. The excellent survival rate after HTx is concomitant with a low incidence of rejection and cardiac allograft vasculopathy.