Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Aug 2013
Does removal of steel wires relieve post-sternotomy pain after cardiac surgery?
Post-sternotomy pain in the absence of cardiac ischemia and sternal instability is most commonly due to the sternal wire sutures or a protruding wire. We performed a retrospective study to investigate the effect of removal of the steel wires for relief of post-sternotomy pain. ⋯ We recommend removal of the steel wires in patients with persistent chest pain after median sternotomy, when sternal instability, mediastinitis, and cardiac causes such as ischemia are excluded.
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Asian Cardiovasc Thorac Ann · Aug 2013
Case ReportsThrombi migration to atrium diagnosed by transesophageal echocardiography.
Two days before surgery in a 70-year-old man with renal cell carcinoma, transthoracic echocardiography showed a dense mass in the inferior vena cava, lying proximally, but no mass was observed in the right atrium. Intraoperative transesophageal echocardiography revealed unexpected tumor thrombi in the right atrium, and the surgical plan was changed. This case highlights the importance of intraoperative transesophageal echocardiography in patients with renal cell carcinoma.
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Asian Cardiovasc Thorac Ann · Aug 2013
Case ReportsRepair of right ventricle rupture caused by left coronary artery occlusion.
A 67-year-old man was admitted with right ventricular free wall rupture secondary to occlusion of the left anterior descending artery. Emergency coronary angiography showed total occlusion of the proximal left anterior descending artery and severe stenosis of the proximal right coronary artery. Echocardiography revealed acute cardiac tamponade, and free wall rupture of the heart was suspected. At surgery under cardiopulmonary bypass, closure was achieved using mattress sutures with pledgets.
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Asian Cardiovasc Thorac Ann · Jun 2013
Randomized Controlled TrialPerioperative use of a beta blocker in coronary artery bypass grafting.
Atrial fibrillation after cardiac surgery is associated with increases in the risk of complications, length of intensive care unit stay, and cost of care. Beta blockers are effective for controlling myocardial ischemia and arrhythmia and suppressing inflammatory cytokines. The purpose of this study was to examine the effect of administrating a short-acting beta-adrenoceptor antagonist, landiolol, on postoperative atrial fibrillation. ⋯ Low-dose continuous infusion of landiolol reduced the incidence of postoperative atrial fibrillation, and significantly suppressed inflammation.
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Asian Cardiovasc Thorac Ann · Jun 2013
Comparative StudyDiabetic control and coronary artery bypass: effect on short-term outcomes.
To evaluate the effect of preoperative glycemic control on hospital morbidity and mortality in diabetic patients undergoing primary coronary artery bypass grafting. ⋯ Short-term outcomes were not affected by the degree of preoperative glycemic control or type of treatment used in diabetic patients undergoing primary coronary artery bypass grafting. A plausible explanation is strict protocol-driven glycemic control in the perioperative period.