The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Meta AnalysisEffect of hydroxyethyl starch on bleeding after cardiopulmonary bypass: a meta-analysis of randomized trials.
The effects of hydroxyethyl starch on bleeding after cardiopulmonary bypass were determined. ⋯ Hydroxyethyl starch increased blood loss, reoperation for bleeding, and blood product transfusion after cardiopulmonary bypass. There was no evidence that these risks could be mitigated by lower molecular weight and substitution.
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Randomized Controlled Trial Multicenter StudyIntermediate-term mortality and cardiac transplantation in infants with single-ventricle lesions: risk factors and their interaction with shunt type.
The study objective was to identify factors associated with death and cardiac transplantation in infants undergoing the Norwood procedure and to determine differences in associations that might favor the modified Blalock-Taussig shunt or a right ventricle-to-pulmonary artery shunt. ⋯ Independent risk factors for intermediate-term mortality include lower socioeconomic status, anatomy, genetic syndrome, and lower gestational age. Term infants with aortic atresia benefited from a right ventricle-to-pulmonary artery shunt, and preterm infants with a patent aortic valve benefited from a modified Blalock-Taussig shunt. Right ventricular function and anatomy, but not shunt type, were associated with transplantation.
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Randomized Controlled TrialLate remote ischemic preconditioning in children undergoing cardiopulmonary bypass: a randomized controlled trial.
Cardiopulmonary bypass is associated with ischemia-reperfusion injury to multiple organs. We aimed to evaluate whether remote ischemic preconditioning performed the day before surgery for congenital heart disease with cardiopulmonary bypass attenuates the postoperative inflammatory response and myocardial dysfunction. ⋯ Late remote ischemic preconditioning did not provide clinically relevant cardioprotection to children undergoing cardiopulmonary bypass.
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Short- and long-term outcomes in patients undergoing valve surgery with end-stage renal failure receiving chronic hemodialysis.
The objective of this study was to evaluate the effect of chronic preoperative hemodialysis for end-stage renal failure in patients undergoing valve surgery. ⋯ In this large cohort of patients, preoperative dialysis conferred a high risk of perioperative morbidity and mortality and poor long-term survival after valve surgery. Risk stratification and future research efforts should focus on more precise identification of the benefits of valve surgery in this high-risk patient population.
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J. Thorac. Cardiovasc. Surg. · Jul 2012
Evolving surgical techniques for pulmonary endarterectomy according to the changing features of chronic thromboembolic pulmonary hypertension patients during 17-year single-center experience.
An increasing number of elderly patients are referred for pulmonary endarterectomy. The distinction between operable and inoperable lesions has been challenged over time. Hence, we developed alternative cardiopulmonary bypass management and cerebral protection strategies to obtain satisfactory surgical results according to the changing patient features. ⋯ In our experience, our alternative strategy resulted in a better combination of surgical accuracy and cerebral protection and improved outcomes.