The heart surgery forum
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The heart surgery forum · Jan 2007
Surgical challenges for urgent approach in penetrating heart injuries.
The aim of this clinical study is to assess the characteristics of penetrating heart injury and its surgical challenges for urgent surgical approach. ⋯ Although the most important factor affecting mortality in penetrating heart injuries is rapid transport, an urgent approach applied by a specialist team can decrease potential mortality and morbidity rates.
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The heart surgery forum · Jan 2007
Case ReportsSuperior vena cava rupture during balloon angioplasty and stent placement to relieve superior vena cava syndrome: a case report.
Percutaneous stenting of the superior vena cava (SVC) has been an accepted therapy for SVC syndrome for more than a decade. Complications are uncommon and usually of minor consequence. ⋯ We report a fourth case of SVC rupture during angioplasty and stenting that required immediate pericardiocentesis followed by open surgical repair via sternotomy for direct control and repair. An algorithm for rapid recognition and prompt intervention is described.
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The heart surgery forum · Jan 2007
Review Meta AnalysisEpidural analgesia in cardiac surgery: an updated risk assessment.
The use of epidural anesthesia carries risks that have been known for 50 years. The debate about the use of locoregional technique in cardiac anesthesia continues. The objective of this report is to estimate the risks and their variability of a catheter-related epidural hematoma in cardiac surgery patients and to compare it with other anesthetic and medical procedures. ⋯ The risk of a hematoma after epidural in cardiac surgery is comparable to other nonobstetrical surgical procedures. Its routine application in a controlled setting should be encouraged.
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The heart surgery forum · Jan 2007
Randomized Controlled TrialPredictive significance of plasma levels of interleukin-6 and high-sensitivity C-reactive protein in atrial fibrillation after coronary artery bypass surgery.
Postoperative atrial fibrillation (AF) plays a major role in the determination of hemodynamic deterioration and can be associated with cardiovascular events after coronary artery surgery. Elevated interleukin (IL)-6 and C-reactive protein (CRP) levels in patients with AF suggest a role of inflammation in the pathogenesis of AF. We conducted a study to investigate the correlation between postoperative AF and IL-6 and high-sensitivity CRP (hsCRP). ⋯ Elevated IL-6 and hsCRP levels in patients with postoperative AF suggest inflammatory components have a role of in the pathogenesis of AF.
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The heart surgery forum · Jan 2007
Comparative Study Controlled Clinical TrialA novel approach for pain management in cardiac surgery via median sternotomy: bilateral single-shot paravertebral blocks.
Regional analgesia has entered cardiac anesthesia in the form of spinal or epidural analgesia. However, the risk of spinal or epidural hematoma is a constant worry. Alternative regional techniques might be applicable in cardiac surgery. ⋯ Postoperative pain scores were at any point significantly lower with TEA, immediately at 2.4 +/- 2.2 versus 3.7 +/- 2.6, at 6 hours at 1.1 +/- 1.5 versus 2.4 +/- 1.8, and at 24 hours at 1.0 +/- 1.4 versus 2.3 +/- 1.6 (0 = no pain, 10 = maximum pain). There was no complications related to epidural catheter placement or BSS-PVB. Using both techniques, immediate extubation after cardiac surgery is feasible; TEA provides better pain relief after cardiac surgery than BSS-PVB.