Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Jul 2014
Randomized Controlled Trial Comparative StudyIntercostal muscle flap and intracostal suture to reduce post-thoracotomy pain.
Thoracotomy is considered to be the most painful surgical access, the main culprit being intercostal nerve injury. Despite the use of many techniques, this remains a major problem, pointing towards prevention as a better strategy. The effect of protecting both the upper and lower intercostal nerves during surgery has attracted many researchers. ⋯ these techniques lead to a reduction in the acute and chronic post-thoracotomy pain, without increasing complications.
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Asian Cardiovasc Thorac Ann · Jul 2014
Randomized Controlled Trial Comparative StudyPatient-controlled analgesia after coronary bypass: Remifentanil or sufentanil?
adequate pain control after cardiac surgery is mandatory to reduce its remarkable morbidity. In this study, we aimed to compare the efficacy of patient-controlled analgesia with remifentanil or sufentanil for pain management after coronary artery bypass grafting. ⋯ our study showed that both remifentanil and sufentanil patient-controlled analgesia can provide acceptable analgesia after coronary artery bypass. The difference between their efficacies was inconspicuous until 24 h postoperatively. Remifentanil seems to result in better pain relief at 24 h postoperatively.
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Asian Cardiovasc Thorac Ann · Jul 2014
Comparative StudyPrior thoracoscopic surgery may improve reoperative pulmonary resection.
although video-assisted thoracoscopic surgery for pulmonary resection appears to be associated with more favorable postoperative outcomes than thoracotomy, no reports have discussed its benefit at subsequent reoperative pulmonary resection. ⋯ our results suggest that prior video-assisted thoracoscopic surgery may lead to improved postoperative outcomes at subsequent reoperative pulmonary resection. Video-assisted thoracoscopic surgery may be favored for future potential reoperative pulmonary resections.
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Asian Cardiovasc Thorac Ann · Jul 2014
Case ReportsA novel modified Robicsek technique for sternal closure: "Double-check".
A median sternotomy is the most common approach for cardiac and great vessel surgery. After a median sternotomy, healing complications such as instability, nonunion, and infection, are rare but devastating. Predisposing factors for sternal complications are old age, diabetes, steroid treatment, postmenopause state, obesity, reoperation, and the use of bilateral internal mammary arteries. ⋯ The technique chosen for sternal closure must provide excellent sternal approximation. We describe a modified Robicsek procedure reinforced with figure-of-8 sternal wires. We named this technique "double-check".
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Asian Cardiovasc Thorac Ann · Jun 2014
Randomized Controlled TrialPreoperative levosimendan in ischemic mitral valve repair.
Levosimendan is a new calcium sensitizing drug with vasodilatory and inotropic properties, which is used for the treatment of postoperative low cardiac output syndrome and difficult weaning from cardiopulmonary bypass. ⋯ Preoperative treatment with levosimendan in patients undergoing coronary artery bypass grafting and mitral valve repair resulted in improved hemodynamics and a stable postoperative course.