Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Sep 2002
ReviewSurgical steps toward complete revascularization in off-pump coronary bypass.
Surgical techniques aimed at complete myocardial revascularization without the use of cardiopulmonary bypass are described. Between January 1998 and June 2000, coronary artery bypass was performed in 3,003 patients; an off-pump technique was used in 676 and cardiopulmonary bypass was employed in 2,327. Patient characteristics, demography, and preoperative risk factors of the two groups were compared retrospectively, and differences in operative variables and postoperative outcomes were analyzed. Using a commercially available suction stabilization device and the surgical and anesthetic techniques described herein, off-pump coronary revascularization was accomplished with results comparable to the on-pump approach.
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Asian Cardiovasc Thorac Ann · Sep 2002
Comparative StudyOff-pump coronary artery surgery in the elderly.
We compared the results of off-pump (n = 186) and on-pump (n = 389) coronary artery bypass grafting in elderly patients over 70 years old. Patients undergoing single-vessel revascularization were excluded from the study. ⋯ The off-pump group fared better in intubation time (16 +/- 4 hours versus 25 +/- 5 hours), blood loss (365 +/- 58 mL versus 584 +/- 72 mL), the need for blood transfusion (31.7% versus 44%), reoperation for bleeding (0.5% versus 3.6%), atrial fibrillation (10.2% versus 18.5%), intensive care unit stay (21 +/- 8 hours versus 34 +/- 10 hours), and total hospital stay (5 +/- 2 days versus 8 +/- 3 days). Off-pump bypass surgery is thus safe for elderly patients and is associated with reduced morbidity and shorter hospitalization than on-pump surgery.
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Asian Cardiovasc Thorac Ann · Sep 2002
Case ReportsRetroesophageal hematoma caused by fish bone perforation of the esophagus.
A 39-year-old man complained of acute dysphagia and dorsal pain while eating fish. Radiologic and endoscopic studies revealed a retroesophageal mass, which was later shown to be a hematoma.
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Asian Cardiovasc Thorac Ann · Jun 2002
Case ReportsRight heart assist during beating bypass for severe left ventricular dysfunction.
Three patients with triple-vessel disease and severe left ventricular dysfunction underwent successful revascularization on a beating heart, using a right ventricular assist system. Heparin-coated circuits with a centrifugal pump provided 2.5 to 3.5 L x min(-1) of flow to maintain good hemodynamics and enable easy access to the posterior vessels during vertical displacement of the heart.