The heart surgery forum
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The heart surgery forum · Jan 2007
Randomized Controlled TrialThe effects of isoflurane, sevoflurane, and desflurane anesthesia on neurocognitive outcome after cardiac surgery: a pilot study.
Inhalation anesthetics such as isoflurane, sevoflurane, and desflurane are widely used in clinical practice; however, there is no study for comparing these drugs in cardiac surgery with respect to postoperative cognitive outcome and S100 beta protein (S100 BP) levels. In this study, we evaluated the effect of sevoflurane, isoflurane, and desflurane anesthesia on neuropsychological outcome and S100 BP levels in patients undergoing coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB). ⋯ Our study suggests that isoflurane is associated with better neurocognitive functions than desflurane or sevoflurane after on-pump CABG. Sevoflurane seems to be associated with the worst cognitive outcome as assessed by neuropsychologic tests, and prolonged brain injury as detected by high S100 BP levels was seen with desflurane.
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The heart surgery forum · Jan 2007
Postoperative outcomes after off-pump coronary artery bypass grafting in EuroSCORE low- and high-risk women.
Many previous studies have reported that women who undergo coronary artery bypass grafting have higher perioperative morbidity and mortality rates than men. The use of off-pump coronary artery bypass grafting (OPCAB) has been suggested to decrease morbidity and mortality because the deleterious effects of cardiopulmonary bypass, particularly in high-risk patients, are avoided. The reduction in unwanted postoperative complications in women undergoing OPCAB surgery has not been extensively investigated. The aim of this retrospective study was to compare perioperative rates of morbidity and mortality and follow-up events after OPCAB in female patients assessed as high- or low-risk according to the European System for Cardiac Operative Risk Evaluation (EuroSCORE). ⋯ These results indicate that OPCAB surgery is safe and seems to be an effective surgical technique for lowering rates of morbidity and mortality in high- and low-risk female patients.
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The heart surgery forum · Jan 2007
Randomized Controlled TrialNormothermia is the key for the treatment of internal thoracic artery spasm.
Free flow of the internal thoracic artery decreases commonly after harvesting because of spasm. Tissue heat loss is inevitable during surgery. The aim of this study was to compare the internal thoracic artery pedicle rewarming method with topical papaverine applications in different thermal conditions. ⋯ Topical application of heated papaverine itself does not warm pedicle tissue, but papaverine efficiency increases when the pedicle is stored in normothermic conditions. Preserving internal thoracic artery pedicles in normothermic conditions can be the preferred treatment for spasms.
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The heart surgery forum · Jan 2007
Randomized Controlled TrialIntravenous and oral amiodarone for the prevention of postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass surgery.
Atrial fibrillation is still a frequent complication that increases morbidity after coronary artery bypass grafting. This prospective randomized study is designed to define efficacy of postoperative amiodarone prophylaxis in preventing atrial fibrillation after off-pump coronary artery bypass grafting. ⋯ Postoperative intravenous amiodarone prophylaxis followed by oral amiodarone significantly reduces the incidence of atrial fibrillation after off-pump coronary artery bypass grafting and the ventricular rate during atrial fibrillation.
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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.