Giornale italiano di cardiologia
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Randomized Controlled Trial Comparative Study Clinical Trial
Beneficial impact of isoflurane during coronary bypass surgery on troponin I release.
Experimental studies indicate that isoflurane, a commonly used volatile anesthetic, mimics the cardioprotective effects of ischemic preconditioning, probably through ATP-sensitive K+ (KATP) channel activation. The aim of this study was to evaluate the impact of isoflurane during coronary bypass surgery (CABG) on troponin I release. ⋯ Isoflurane reduces myocardial injury in patients with impaired left ventricular function undergoing CABG; thus, it can be safely used as an additional cardioprotective tool during routine CABG in high-risk patients with poor left ventricular function.
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Comparative Study
Factors influencing outcome after emergency surgical repair of acute type A aortic dissection.
We retrospectively reviewed our more recent experience with acute type A aortic dissection in order to identify possible risk factors influencing current surgical results. ⋯ Current results of emergency repair of acute type A aortic dissection are strictly dependent on the number of complicated cases referred for operation. Earlier diagnosis and prompt referral before development of preoperative complications appear essential to improve surgical results.
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A case is reported in which a 31-years-old man experienced coronary artery dissection with an acute anterior myocardial infarction following blunt chest trauma in a car accident. Due to ECG signs of acute myocardial infarction a coronary angiography was performed showing an abrupt occlusion of the mid part of the left anterior descending artery and a linear filling defect in the proximal portion of the vessel. ⋯ Two vein grafts were made from aorta to the left anterior descending artery and the circumflex artery, respectively. Repeat angiography was performed early after the operation; dissection of the left main and the left anterior descending artery was still visible and the grafts to the left descending artery and the circumflex were patent.