Journal of cardiac surgery
-
Clinical Trial
Risk factors for prolonged stay in the intensive care unit and on the ward after cardiac surgery.
Prolonged length of stay (LOS) after cardiac surgery has been associated with poor outcome and a considerable expenditure of health care resources. As our patient's demographics are changing, a continuing evaluation of the preoperative and intraoperative variables affecting LOS in the intensive care unit (ICU) and on the floor remains important. ⋯ In this series of 426 consecutive patients, we have identified several perioperative risk factors associated with prolonged hospitalization that can help clinicians in their preoperative patient counseling, risk stratification, and selection. However, the most obvious use of these results is in allowing decision makers to implement specific strategies that would best allocate resources depending on the risk profile of cardiac patients.
-
We present a rare case of bullet embolism from the left brachiocephalic vein to the right ventricle, following a chest gunshot wound, in a 56-year-old soldier. The bullet was accidentally discovered on a systematic chest X-ray. The bullet was very close to the tricuspid subvalvular apparatus and was about to come out from the ventricle. We removed it under cardiopulmonary bypass.
-
Review Meta Analysis
Preoperative intra-aortic balloon pump in patients undergoing coronary bypass surgery: a systematic review and meta-analysis.
To assess the effectiveness of preoperative intra-aortic balloon pump (IABP) placement in high-risk patients undergoing coronary bypass surgery (CABG). The primary outcome was hospital mortality and secondary outcomes were IABP-related complications (bleeding, leg ischemia, aortic dissection). ⋯ Evidence from this meta-analysis support the use of preoperative IABP in high-risk patients to reduce hospital mortality.
-
The foramen ovale remains patent in about 25% of the population. Paradoxical embolism through a patent foramen ovale (PFO) may produce ischemic events. The closure of a PFO may prevent recurrence of cerebrovascular events. Percutaneous closure of a PFO is now-a-days a standard procedure and it appears to carry a low rate of complications. A surgical approach, in some cases, may be needed. ⋯ Minimally invasive surgery may be effective to treat PFO or even complications after previous percutaneous attempts of closure. An aesthetically acceptable conclusion, especially in young female patients, and a very low rate of morbidity may be accomplished.
-
Randomized Controlled Trial Comparative Study
Sixteen-slice multidetector computed tomography for graft patency evaluation after coronary artery bypass surgery.
To investigate the ability of 16-slice multidetector computed tomography (MDCT) to assess coronary artery bypass graft patency and to detect bypass stenosis by comparison with coronary angiography. ⋯ Sixteen-slice MDCT allows for noninvasive evaluation of coronary bypass grafts patency with high diagnostic accuracy. Assessment of distal anastomotic stenosis was deficient, particularly for arterial grafts, still limited by low resolution or artifacts. Improved accuracy may be obtained by more aggressive heart rate reduction.