The heart surgery forum
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The heart surgery forum · Apr 2010
Comparative StudyNoninvasive mechanical ventilation in patients with acute respiratory failure after cardiac surgery.
To evaluate the feasibility and outcomes of protocol-driven noninvasive mechanical ventilation in patients with acute respiratory failure (ARF) after cardiac surgery. ⋯ Our study demonstrates the feasibility of NIV in patients after cardiac surgery. These results might suggest that NIV should be considered as first-line ventilatory support in ARF after cardiac surgery. A large randomized trial is warranted to confirm these findings.
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The heart surgery forum · Apr 2010
Comparative StudyInfective endocarditis complicated by paravalvular abscess: a surgical challenge. An 11-year single center experience.
To evaluate the impact of paravalvular abscess in the surgical management and outcome of infective endocarditis. ⋯ Considering the severity of the onset, a radical surgical treatment delivers acceptable long-term results by acceptable operative mortality. The choice of the prosthetic device seems not to be influential in long-term survival and morbidity.
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The heart surgery forum · Apr 2010
Comparative StudyThe analgesic efficacy of local anesthetics for the incisional administration following port access heart surgery: bupivacaine versus ropivacaine.
To avoid large dose opioids, the authors investigated an alternative method for postoperative pain relief after Port Access cardiac surgery. ⋯ Both local anesthetics, ropivacaine and bupivacaine, are equally effective for pain relief after Port Access cardiac surgery. The catheter in surgical incision and application of LA through it does not increase the risk for wound infection and does not interfere with wound healing.
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The heart surgery forum · Oct 2009
Randomized Controlled Trial Comparative StudyWhich is first: left anterior descending artery anastomosis or right coronary artery anastomosis in off-pump coronary artery bypass grafting?
The sequence of the distal anastomosis for revascularization in off-pump coronary artery bypass grafting (OPCABG) surgery is under debate. The hypothesis in this study was that an analysis of cardiac markers would reveal that anastomosing the left anterior descending coronary artery (LAD) before the right coronary artery (RCA) would decrease myocardial damage in OPCABG surgery for 2-vessel disease. ⋯ Anastomosis to the LAD first in OPCABG surgery led to a slight reduction in myocardial enzyme release against the occlusion of the target vessels during anastomoses in patients with RCA and LAD stenoses.
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The heart surgery forum · Oct 2009
Randomized Controlled TrialComparison of continuous and intermittent transcutaneous electrical nerve stimulation in postoperative pain management after coronary artery bypass grafting: a randomized, placebo-controlled prospective study.
We compared the effectiveness of continuous transcutaneous electrical nerve stimulation (TENS) and intermittent TENS in the management of pain after coronary artery bypass grafting (CABG). ⋯ CTENS and ITENS after median sternotomy for CABG decreased pain and reduced narcotic requirements more than in the PTENS and control treatments during first postoperative 24 hours. Neither CTENS nor ITENS is superior to the other in decreasing pain; however, CTENS leads to a greater reduction in the narcotic requirement than ITENS.