Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Comparative StudyThromboelastography with heparinase in orthotopic liver transplantation.
To investigate the role of heparin in the postreperfusion coagulopathy during liver transplantation with heparinase-guided thromboelastography. ⋯ Heparinase-treated thromboelastography offered compelling evidence for the presence of heparin-like activity after liver graft reperfusion. The objective evidence provided by this modification of thromboelastography-guided protamine administration and was useful in identifying one of the many potential causes of postreperfusion bleeding in patients undergoing OLT.
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Comparative StudyShort atrioventricular delay dual-chamber pacing early after coronary artery bypass grafting in patients with poor left ventricular function.
To investigate the effect of short atrioventricular (AV) delay dual-chamber pacing on mean arterial pressure (MAP) and stroke volume index (SVI) in patients with poor left ventricular (LV) function after cardiac surgery. ⋯ Dual-chamber pacing with nonphysiologic short AV delay failed to improve acute hemodynamics in patients with poor LV function after CABG. Short AV delay VDD pacing was superior to DDD pacing in both normal and impaired LV function. The use of Doppler echocardiography enabled optimization of the AV delay on the basis of LV filling patterns.
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Anesthesia for deep hypothermic circulatory arrest in adults: experience with the first 50 patients.
To evaluate the efficacy of a simple method of central nervous system (CNS) protection in patients undergoing deep hypothermic circulatory arrest (DHCA) lasting less than 30 minutes, for a variety of complex cardiovascular procedures. ⋯ The anesthetic management of DHCA described is simple, effective, and safe, and can be performed in any institution that performs cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 1998
Comparative StudyCerebral complications after coronary artery bypass and heart valve surgery: risk factors and onset of symptoms.
Cerebral complications continue to be a major cause of morbidity after cardiac surgery. Earlier studies have mainly focused on intraoperative events, but symptoms may also occur later in the postoperative period. The purpose of this study was to determine the incidence and risk factors of focal neurologic complications and timing of cerebral symptoms. ⋯ Cerebral complications may be delayed after cardiac surgery, suggesting causes of cerebral damage other than intraoperative events. Valve-surgery patients had the lowest incidence and patients with combined procedures had the highest incidence of cerebral complications. Advanced age, diabetes mellitus, and preexisting cerebrovascular disease increased the risk.