The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Randomized Controlled TrialGentamicin-collagen sponge reduces sternal wound complications after heart surgery: a controlled, prospectively randomized, double-blind study.
Prophylactic retrosternal placement of a gentamicin-collagen sponge has been the subject of several recent clinical studies and is a matter of controversy. The present study is the first controlled, prospective, randomized, double-blind, single-center study to investigate the efficacy of a retrosternal gentamicin-collagen sponge in reducing sternal wound complications after heart surgery. ⋯ Routine prophylactic retrosternal use of a gentamicin-collagen sponge in patients undergoing cardiac surgery significantly reduces deep sternal wound infections.
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Comparative StudyOff-pump coronary artery bypass grafting does not preserve renal function better than on-pump coronary artery bypass grafting: results of a case-matched study.
Controversy exists regarding the perioperative renal effects of off-pump versus on-pump coronary artery bypass grafting. Large case-matched and randomized comparisons have shown conflicting results. This study focuses on this clinical controversy. ⋯ Off-pump coronary artery bypass grafting does not preserve renal function to a greater extent than on-pump coronary artery bypass grafting. In fact, a trend to the reverse exists with no clinically harmful effects.
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Predictive value of near-infrared spectroscopy on neurodevelopmental outcome after surgery for congenital heart disease in infancy.
To explore the relationship between intraoperative regional cerebral oxygen saturation (rSO(2)) measured by near-infrared spectroscopy (NIRS) and neurodevelopmental outcome in children after cardiac surgery. ⋯ In a contemporary cohort of infants undergoing surgery for congenital heart disease, neurodevelopmental outcomes at 2 years of age are largely influenced by patient-related characteristics. Although receptive communication appears to be influenced by rSO(2) nadir, the predictive value of NIRS remains unclear.
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J. Thorac. Cardiovasc. Surg. · Jan 2012
Comparative StudyTranscatheter aortic valve implantation versus surgical aortic valve replacement: a propensity score analysis in patients at high surgical risk.
Transcatheter aortic valve implantation (TAVI) has recently been advocated to decrease perioperative risk in high-risk patients. In this propensity-score analysis we compared outcomes after TAVI to those after surgical aortic valve replacement (AVR). ⋯ In our experience, mortality rates are similar after both types of procedure. Patients receiving TAVI benefit from faster postoperative recovery. Until more clinical data become available, the optimal procedure has to be determined for each patient according to individual risk factors.