J Cardiovasc Surg
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To determine the incidence and predictors of postoperative myocardial ischemia in non-coronary risk patients undergoing surgery for thoracic aortic aneurysms. ⋯ The use of total cardiopulmonary bypass is predictive of perioperative myocardial ischemia in surgery for thoracic aortic aneurysms, probably due to the production of proinflammatory cytokines by systemic ischemia and reperfusion. Prophylactic use of coronary vasodilators may be validated in these cases.
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Recovery following successful coronary artery bypass grafting (CABG) has been dramatically improved with the use of fast-track methods. Although data exist that demonstrate a significant gender difference in survival following CABG, little is known about factors influencing gender-specific recovery. This report describes a series of consecutive patients undergoing isolated CABG to determine gender-associated factors that may impact outcomes and recovery. ⋯ Women had similar operative mortality and postoperative complication rates to men under a rapid recovery protocol. However, women have a longer recovery interval compared to men, which may be a reflection of their higher preoperative risk profile.
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Randomized Controlled Trial Clinical Trial
A comparison of ischemic preconditioning versus terminal warm cardioplegia with controlled reperfusion in open heart operation.
The purpose of this study was to evaluate the effects of three different methods of cardioprotection in patients undergoing valve replacement. ⋯ Terminal warm cardioplegia with controlled aortic root reperfusion and ischemic preconditioning equally improve cardiac function and reduce the requirement of inotropic agents in patients undergoing valve replacement.
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The purpose of this study was to investigate the influence of coronary artery bypass grafting on the degree of stenosis of the native coronary artery. ⋯ Coronary artery bypass grafting with saphenous vein grafts may result in progression of stenosis of the recipient coronary artery. This is less likely after coronary artery bypass grafting with internal thoracic artery grafts. This difference may be due to the ability of the pedicled internal thoracic artery graft to regulate flow. Thus competitive flow in the native coronary artery is minimized. This has significant clinical implications.
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Ruptured anastomotic aneurysms after aortobifemoral surgery are potentially life threatening. The preferred technique consists of resection of the pseudoaneurysm and interposition of a new graft. We present a case in which an endovascular approach was chosen for treatment of a ruptured femoral false aneurysm. An endograft was inserted and complete exclusion of the pseudoaneurysm was achieved.