The heart surgery forum
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The heart surgery forum · Dec 2014
Readmission to the intensive care unit in times of minimally invasive cardiac surgery: does size matter?
It is well known that patients who undergo readmission to an intensive care unit (ICU) after cardiac surgery face an increased risk of morbidity and mortality. The present study sought to evaluate whether less invasive procedures might be associated with a reduction of this economically as well as individually important problem. The role of the quantity of ICU and intermediate care (IMC) beds was investigated as well. ⋯ Readmission to the ICU after cardiac surgery is associated with impaired outcome. Extended resources in terms of ICU and IMC capacity may positively influence this problem by decreasing the number of readmissions. Modern surgical strategies with less invasive procedures may be associated with a reduced incidence of readmission as well.
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The heart surgery forum · Dec 2014
Clinical TrialPericardiectomy: prompt surgical management of constrictive pericarditis.
Constrictive pericarditis is a slow progressive fibrosis of the pericardium leading to a variety of symptoms and signs over time. The disease poses a diagnostic challenge; restrictive cardiomyopathy and other syndromes associated with right-sided pressure abnormalities share similar symptoms and clinical findings. Pericardiectomy is considered the treatment of choice for constrictive pericarditis. Here we studied the effects of total radical pericardiectomy on hemodynamics in 37 patients diagnosed with constrictive pericarditis. ⋯ Radical pericardiectomy is a demonstrably useful procedure for correction of hemodynamic abnormalities and improvement of overall heart function in symptomatic patients with constrictive pericarditis.
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The heart surgery forum · Oct 2014
Case ReportsA case of Heyde syndrome: resolution following aortic valve replacement.
Heyde syndrome is a triad of aortic stenosis, acquired coagulopathy, and anemia due to bleeding from intestinal angiodysplasia. Here we describe a case of this syndrome. An 80-year-old woman with severe aortic stenosis was referred to our department for an aortic valve replacement. ⋯ She was discharged on postoperative day 22. No transfusions were needed after the procedure. To date, her hemoglobin has remained stable at >10 mg/dL.
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The heart surgery forum · Oct 2014
Randomized Controlled TrialThe effect of lidocaine and amiodarone on prevention of ventricular fibrillation in patients undergoing coronary artery bypass grafting.
Ventricular fibrillation is common after aortic declamping in patients undergoing open heart surgery. This situation has a negative impact on morbidity and mortality. The aim of this prospective study was to compare the effect of administering lidocaine versus amiodarone before aortic declamping during elective coronary bypass grafting, paying close attention to when the initial effect of amiodarone sets in. ⋯ We suggest that during coronary arterial bypass surgery, administration of an amiodarone regime before release of the aortic cross clamp, paying particular attention to the start of the initial effect of amiodarone, is no more effective than lidocaine for prevention from arrhythmia; however, amiodarone reduces the need for electrical defibrillation.
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The heart surgery forum · Oct 2014
Case ReportsImproved angiographic findings of superficial femoral artery after verapamil injection into the reperfusion cannula of a patient on peripheral venoarterial ECMO.
Limb ischemia is a complication that can occur in patients requiring percutaneously placed venoarterial extracorporeal membrane oxygenation (ECMO). One method used to prevent limb ischemia is the placement of an antegrade catheter into the superficial femoral artery. We describe a case is which the angiographic findings of the superficial femoral artery were improved by the injection of verapamil in a patient with limb ischemia.