Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Jun 2007
Randomized Controlled Trial Comparative StudyNear-infrared spectroscopy monitoring of brain oxygen in infant cardiac surgery.
The use of near-infrared spectroscopy for monitoring cerebral oxygenation during different types of cardiopulmonary bypass was evaluated in 24 patients aged 5 to 13 months. They underwent open-heart surgery under cardiopulmonary bypass with moderate hypothermia, deep hypothermia with low flow, or deep hypothermia with circulatory arrest. Near-infrared spectroscopy data were compared with electroencephalography and biochemical indicators (neuron-specific enolase, lactate). ⋯ The period from reaching the nadir until reperfusion and the minimum values of oxygenated hemoglobin correlated closely with increases in neuron-specific enolase and lactate. All patients with an oxygenated hemoglobin-signal nadir time < 35 min were free from behavioral evidence of brain injury. The oxygenated hemoglobin-signal nadir time may be useful in predicting the safe duration of circulatory arrest.
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Asian Cardiovasc Thorac Ann · Jun 2007
Case ReportsLupus anticoagulant and off-pump coronary bypass: dilemma of anticoagulation.
Confronted with a persistently elevated activated partial thromboplastin time due to circulating lupus anticoagulant in a patient undergoing emergency off-pump coronary artery bypass surgery, the dilemma of providing adequate anticoagulation for a short cardiac surgical procedure is highlighted.
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Asian Cardiovasc Thorac Ann · Jun 2007
Randomized Controlled Trial Comparative StudyEndothoracic papaverine application for internal thoracic artery harvest.
This study compared the effects of different methods of papaverine application on free blood flow and harvesting time of the internal thoracic artery for coronary bypass grafting. Patients were randomly divided into 3 groups of 25 each: group 1 had papaverine injected into the endothoracic tissue around the internal thoracic artery before dissection, group 2 had papaverine injected into the periarterial tissues of the internal thoracic artery pedicle, and group 3 had intraluminal papaverine applied retrogradely into the internal thoracic artery. Mean blood flow was 56.3 +/- 21.3, 21.1 +/- 13.2, and 20.9 +/- 9.1 mL x min(-1) in groups 1, 2, and 3, respectively, immediately after harvesting. ⋯ Immediately before anastomosis, mean flow was 89.8 +/- 19.1, 97.6 +/- 35.4, and 95.9 +/- 19.9 mL x min(-1) in groups 1, 2, and 3, respectively, with no significant difference among groups. Internal thoracic artery harvesting times were shorter in group 1 than in groups 2 and 3. Administering papaverine into the endothoracic fascia of the internal thoracic artery bed prior to dissection is a reliable method that facilitates rapid harvesting of the graft without causing trauma and consequent spasm.
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Asian Cardiovasc Thorac Ann · Jun 2007
Case ReportsDiaphragmatic laceration, partial liver herniation and catamenial pneumothorax.
Catamenial pneumothorax is a recurrent pneumothorax temporally associated with menstruation. Pathogenesis remains debated however pleural endometriosis or diaphragmatic abnormalities are almost always present. ⋯ Treatment involved repair of the diaphragmatic lacerations, and pleurodesis. This report shows that large diaphragmatic defects may be observed in patients with catamenial pneumothorax.
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Asian Cardiovasc Thorac Ann · Jun 2007
Minimally invasive aortic valve replacement in left ventricular dysfunction.
The safety and benefit of minimally invasive aortic valve replacement in patients with left ventricular dysfunction has not been well investigated. We conducted a retrospective review of 140 patients with ejection fraction