The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2010
Randomized Controlled TrialThromboelastometrically guided transfusion protocol during aortic surgery with circulatory arrest: a prospective, randomized trial.
Aortic surgical procedures requiring hypothermic circulatory arrest are associated with altered hemostasis and increased bleeding. In a randomized clinical trial, we evaluated effects of thromboelastometrically guided algorithm on transfusion requirements. ⋯ Thromboelastometrically guided transfusion is associated with a decreased use of allogeneic blood units and reduced incidence of massive transfusion in patients undergoing aortic surgery with circulatory arrest.
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J. Thorac. Cardiovasc. Surg. · Nov 2010
Infections occurring during extracorporeal membrane oxygenation use in adult patients.
The application of extracorporeal membrane oxygenation in adults has been increasing, but infections occurring during extracorporeal membrane oxygenation use are rarely described. ⋯ Bloodstream infection was the most common infection during extracorporeal membrane oxygenation use. Duration of extracorporeal membrane oxygenation, mechanical complications, autoimmune disease, and venovenous mode seemed to be independently associated with infections.
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J. Thorac. Cardiovasc. Surg. · Nov 2010
Cardiac catheterization within 24 hours of valve surgery is significantly associated with acute renal failure.
Acute renal failure after valve surgery carries significant morbidity and mortality. Preoperative cardiac catheterization is the standard of care. For convenience, catheterization just before surgery is simplest for patients. However, it is not known if this timing of radiocontrast administration significantly affects renal function. We hypothesized that preoperative cardiac catheterization within 24 hours of valve surgery is associated with the development of acute renal failure. ⋯ Although catheterization is often performed for patient convenience, catheterization within 24 hours of valve surgery is significantly associated with the development of acute renal failure. Current practices should be adjusted to ensure that more than 24 hours have passed from the time of cardiac catheterization to valve surgery in elective settings.
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J. Thorac. Cardiovasc. Surg. · Nov 2010
Determinants of outcome after surgical treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries.
Identification of variables influencing surgical outcome in patients treated for pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. ⋯ The results of surgery were satisfactory and durable, despite the need for repeated percutaneous or surgical reinterventions. The outcomes were negatively affected by neonatal age and low body weight and positively affected by simultaneous or staged ventricular septal defect closure. Finally, chromosome 22q11 deletion remained an independent variable affecting survival.