Journal of cardiac surgery
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Case Reports
Traumatic chylothorax following blunt thoracic trauma: two conservatively treated cases.
Chylothorax is rare following blunt thoracic trauma; its diagnosis is usually delayed until the puncture or drainage of posttraumatic pleural effusion and its cause is not clear. Mostly, it is attributed to injury or overstretching of major thoracic duct by fractures or other injury of neighboring thoracic spine. ⋯ Both cases were successfully treated after 16 and 23 days, respectively, with drainage, starvation, reexpansion of the lung(-s), and total parenteral nutrition. We believe that with the "triad of RST" ("reexpansion, starvation diet, TPN"), conservative treatment will be successful in the majority of cases.
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Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a mechanical circulatory support indicated for the advanced treatment of refractory heart failure. The cannulation of the femoral vessels may be complicated by distal limb ischemia by arterial hypoperfusion and severe edema by venous obstruction. We describe a modified cannulation technique in order to prevent ischemia and edema of the inferior limb during VA-ECMO.
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Comparative Study
Superior flow pattern of internal thoracic artery over saphenous vein grafts during OPCAB procedures.
The advantages of the use of the internal thoracic artery (ITA) over that of the saphenous vein (SV) for revascularization of the circumflex (Cx) or right coronary artery (RCA) are still debated. ⋯ The internal thoracic artery provides superior flow properties than the SV to the Cx and RCA regions with reduced perioperative ischemia. Whether this advantage persists after adjusting for the grade of the proximal coronary stenosis needs further studies.
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We retrospectively reviewed the long-term outcome of atrial isomerism patients after Fontan completion. ⋯ There are still life-threatening problems 10 years after the UVR. However, the excellent performance status of the present long-term survivors suggests that these problems can all be overcome by the present strategies established for the Fontan-type operation.
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The purpose of this prospective study was to evaluate the current incidence, survival, morbidity, and predictors of mortality for open sternotomy at our center. ⋯ This study shows that open chest with DSC is useful in the treatment of postoperatively impaired cardiac function, intractable bleeding, and persistent arrhythmias. It can be carried out with a relatively low incidence of sternal complications. Patients with new onset acute renal failure and who require IABP continue to have a high mortality rate.