Journal of cardiac surgery
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Review Meta Analysis
Early extubation after pediatric cardiac surgery: systematic review, meta-analysis, and evidence-based recommendations.
To derive evidence-based recommendations regarding early extubation strategy after congenital cardiac surgery. ⋯ Early extubation appears safe and is associated with reduction in length of ICU and hospital stay without adverse effects on mortality or morbidity. However, studies to date are poor, heterogeneous, and not suitable to determine a causal effect. Therefore, there is need for a well-designed randomized clinical trial to demonstrate the potential significant benefits of early extubation.
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Review Case Reports
Cardiac arrest with "pseudo-Brugada" ECG pattern in the setting of a coronary artery anomaly.
A 36-year-old Hispanic man with no prior cardiac history presented with chest pain and then ventricular fibrillation requiring defibrillation after a physical altercation. His ECG on presentation to the emergency room was suggestive of Brugada syndrome, which later normalized. Cardiac catheterization revealed anomalous origin of right coronary artery from the left coronary cusp (coursing between the pulmonary artery and the aorta) for which he underwent surgical reimplantation, and subsequent pharmacological challenge test did not provoke reappearance of a Brugada ECG pattern. A review of literature on Brugada syndrome and anomalous origin of the coronary arteries is presented.
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The use of cardiopulmonary bypass during coronary artery bypass grafting (CABG) surgery has been associated with substantial morbidity. Off-pump coronary bypass (OPCAB) surgery has become a widely used technique during recent years. EuroSCORE risk scale is the most rigorously evaluated scoring system in cardiac surgery to preoperatively quantify the risk of death and other serious postoperative complications. The aim of this prospective observational study was to compare the mortality and morbidity between OPCAB and conventional CABG in three major preoperative groups as assessed by EuroSCORE. ⋯ OPCAB does not offer any significant advantage in terms of mortality and morbidity over conventional CABG.
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Case Reports
Acute anterolateral papillary muscle rupture in the absence of coronary artery disease.
Acute papillary muscle rupture is usually associated with a myocardial infarction and involves the posteromedial muscle. We present a case of spontaneous rupture of the anterolateral papillary muscle due to an isolated infarct of the papillary muscle in the absence of epicardial coronary artery disease.