J Cardiovasc Surg
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The aim of this study was to evaluate the efficacy and cost-effectiveness of fibrinogen/thrombin-coated collagen patch (FTCCP)(TachoSil®) during intraoperative hemostasis in patients with congenital heart disease, who required a reoperation during childhood. ⋯ FTCCP is an effective hemostatic agent which can be safely used during the hemostasis of children requiring reoperations for their congenital heart malformations. When used as first line treatment, with specific indications, FTCCP limited the intraoperative PRBC requirement and the use of other hemostatic/sealant agents thus reducing hospital costs.
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Randomized Controlled Trial
Lack of renal protection of ultrafiltration during cardiac surgery: a randomized clinical trial.
The objective of this study was to determine the intraoperative ultrafiltration effect on postoperative AKI. ⋯ Routine use of ultrafiltration during cardiac surgery offers no advantages in renal protection and reduction of AKI incidence.
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Endoscopic radial artery (RA) graft harvesting in coronary artery bypass surgery (CABG) is attractive but concern remains regarding early graft failure. We evaluated RA graft patency via intraoperative graft flow measurements and mid-term computerized tomography angiography (CTA). ⋯ The RA of appropriately selected patients can be harvested safely by endoscopic technique and can be used as sequential grafts for CABG with satisfactory outcomes. Intraoperative flow measurement can assure the quality of the grafts. CTA is a valuable tool for patency follow-up.
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Review
Management of bicuspid aortic valve with or without involvement of ascending aorta and aortic root.
Patients with a bicuspid aortic valve (BAV) constitute a heterogeneous population with variable clinical presentation and complications. More than 50% of the patients who require aortic valve replacement have a BAV, a condition that may be associated with dilation of ascending aorta and aortic insufficiency caused by cusp disease or aortic root pathology. Of the potential BAV-related complications, dilation of the aortic root and ascending aorta are among the most serious. ⋯ Whereas some surgeons believe that the dilation of the aorta is caused by the hemodynamic properties of the BAV, others believe that the dilation of the aortic root is secondary to genetic defects associated with the BAV. Management of a BAV should be tailored to each patient's clinical condition. The surgical approach varies from aortic valve replacement to combined aortic valve and root replacement to aortic-valve-sparing root replacement.