J Cardiovasc Surg
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Late cardiac tamponade after open heart surgery is a relatively uncommon, but potentially serious complication. We retrospectively analyzed 14 patients who had posterior cardiac tamponade 13 to 210 days after open heart surgery. ⋯ 2-D echocardiography guid pericardiocentesis through left anterior axillary line was found to be a useful, safe, and simple technique. It can be used as an alternative treatment to surgical pericardiotomy for posterior cardiac tamponade after open heart surgery.
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Case Reports
Pseudoaneurysm of the left ventricle following repair for ventricular septal perforation.
The patient was a 64-year-old man who was treated surgically for an infarct-related ventricular septal perforation. Pseudoaneurysm of the left ventricle was recognized on the 38th postoperative day. ⋯ It seemed that insufficient resection of the infarcted myocardium was performed during the initial surgery to avoid narrowing the ventricular dimension by direct closure of the left ventricle, but this resulted in pseudoaneurysm of the left ventricle. Left ventricular free wall plasty with a patch should be performed during the initial surgery.
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We describe a simple technique to prevent the lower limb ischemia during femoral veno-arterial cardiopulmonary support (CPS). ⋯ Active perfusion through a 14-gauge Teflon catheter downstream to the ipsilateral SFA is effective in preventing lower limb ischemia during prolonged femoral veno-arterial CPS after cardiac surgery.
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We hypothesized that the relationship between oxygen delivery (DO2) and oxygen consumption (VO2) in patients undergoing cardiopulmonary bypass (CPB) may differ from the normal physiologic state because of oxygen debts acquired during CPB. Blood gas analysis and hemodynamic parameters were repeatedly measured for determination of DO2 and VO2 in 40 patients undergoing CPB every 8 hours during the first 48 hours postoperatively. Twenty patients of acute myocardial infarction (AMI) also were studied in the same protocol as controls. ⋯ However, such supply-dependent oxygen consumption was not observed in the AMI patients. Perioperative parameters which had a significant relationship with oxygen extraction rate (VO2/DO2 x 100) were Hb concentration, cardiac index, systemic vascular resistance, age of the patients, duration of CPB, SaO2 and SvO2. These results suggest that patients undergoing CPB need a much higher oxygen supply to recover from the oxygen debt during open heart surgery.
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Thirty four children with blunt thoracic trauma were treated at the university hospital, Trabzon. Eighteen of them were sustained in motor vehicle accidents, 14 were falls and two were a result of miscellaneous causes. Rib fracture developed in 16 patients and pulmonary contusion occurred in 18 patients. ⋯ Complications developed in five patients. Four patients were lost due to multiple system injuries. In this study, the injury patterns, complications and mortality of blunt thoracic injuries were discussed.