The heart surgery forum
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The heart surgery forum · Aug 2009
Clinical TrialAbility of B-type natriuretic peptide in predicting postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting.
Atrial fibrillation (AF) is still the most frequent rhythm disturbance after coronary artery surgery. Our aim was to evaluate the predictive value of preoperative brain natriuretic peptide (BNP) levels for determining postoperative new-onset AF in patients undergoing isolated first-time coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB). ⋯ Elevated preoperative BNP levels and advanced age together are significant predictors for the development of postoperative AF in patients undergoing isolated CABG with CPB.
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The heart surgery forum · Aug 2009
Favorable early outcomes for patients with extended indications for thoracic endografting.
Endografts originally designed and approved for the treatment of thoracic aortic aneurysms have rapidly been adopted for nonapproved use in the treatment of disorders of the thoracic aorta, including aortic transection, dissection, pseudoaneurysms, and thoracoabdominal aneurysms. The purpose of this study was to evaluate the early outcomes of patients treated with thoracic endografts for nonapproved indications at our institution. ⋯ Thoracic endografts are versatile devices that with appropriate expertise can be used effectively to treat a spectrum of disorders of the thoracic aorta, including acute emergencies. Early outcomes of patients with extended indications for thoracic endografting compare favorably to published series of patients treated with open procedures. Further study is required to assess the long-term efficacy of these devices.
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The heart surgery forum · Aug 2009
Antegrade cerebral perfusion during deep hypothermia circulatory arrest attenuates the apoptosis of neurons in porcine hippocampus.
Cerebral damage is a major problem after reconstructive surgery of the aortic arch and the descending aorta. Current protective strategies, including deep hypothermia and antegrade cerebral perfusion (ACP), are used to prolong the tolerated duration of circulatory arrest. The aim of the study was to observe the influence of deep hypothermic circulatory arrest (DHCA) and ACP on neuronal apoptosis in the hippocampus. To further elucidate the mechanisms of neurologic injury and protection, we assessed the expression of the antiapoptotic protein Bcl-2 and the proapoptotic protein Bax. ⋯ DHCA can induce neuronal apoptosis in the hippocampus. ACP during the DHCA period protects cerebral tissue by suppressing apoptosis through decreasing Bax expression and increasing Bcl-2 expression.