Minerva cardioangiologica
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Minerva cardioangiologica · Oct 2008
Randomized Controlled Trial Comparative StudyCarotid endarterectomy: comparing anesthesia in awakened and intubated patients with general anesthesia.
The purpose of this study was to determine utility and efficacy of anesthesia with remifentanil in awakened and intubated patients in comparison with general anesthesia and routine shunting. ⋯ General anesthesia with remifentanil produces an association between the advantage of locoregional anesthesia and those of general anesthesia, probably lowering the risk for the patients.
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Minerva cardioangiologica · Aug 2008
ReviewVolatile anesthetics for periprocedural cardiac protection. A review.
All volatile anesthetics have cardiac depressant effects that decrease myocardial oxygen demand and may, therefore, have a beneficial role on the myocardial oxygen balance during ischemia. Recently, experimental evidence has clearly demonstrated that in addition to these indirect protective effects, volatile anesthetic agents also have direct protective properties against ischemic myocardial damage. ⋯ Multicenter, randomized clinical trials had previously demonstrated that the use of desflurane can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization, following coronary artery bypass graft surgery, either with and without cardiopulmonary bypass. Evidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanism of cardiac protection by volatile agents.
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Minerva cardioangiologica · Aug 2008
Use of Impella Recover 2.5 left ventricular assist device in patients with cardiogenic shock or undergoing high-risk percutaneous coronary intervention procedures: experience of a high-volume center.
Percutaneous coronary interventions are increasingly applied to high-risk patients. The availability of hemodynamic support devices offers a promising option to prevent and treat low-output syndrome in these patients. The aim of this study was to evaluate the feasibility, safety and efficacy of the Impella Recover'' LP 2.5 left ventricular assist device in patients with cardiogenic shock or undergoing high-risk percutaneous coronary interventions. ⋯ These data, although preliminary due to the limited sample size, demonstrated the feasibility, safety and efficacy of the Impella Recover LP 2.5 during high-risk percutaneous procedures, even though the benefits of prophylactic deployment of such a system have to be further investigated. The use of Impella Recover LP 2.5 in patients with cardiogenic shock is feasible and safe, however it maybe insufficient in reversing an advanced cardiogenic shock which, probably, has to be treated with more powerful left ventricular assist devices.
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Minerva cardioangiologica · Feb 2008
Comparative Study Clinical TrialSirolimus, Tacrolimus and Zotarolimus eluting stents to treat bifurcated lesions: a 7-month clinical outcome comparison.
Drug eluting stents (DES) have been shown to reduce restenosis compared with bare metal stents in bifurcated lesions. The aim of this study was to evaluate the long-term clinical outcomes of patients with bifurcated lesions treated by 3 different DES. ⋯ The clinical outcome of bifurcated lesions using DES and mainly a technique of single stent implantation is good. In the present observational study, clinical adverse events did not differ in patients with bifurcated lesions treated by Cypher, Taxus or Endeavor stent implantation.
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Minerva cardioangiologica · Feb 2008
Editorial ReviewTowards defining the role of drug eluting stents.