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
Controlled Clinical TrialGenetic polymorphisms contribute to acute kidney injury after coronary artery bypass grafting.
Acute kidney injury is one of the most serious complications after cardiac surgery. Genetic polymorphisms are reported to be associated with postoperative renal impairment. The aim of this study was to investigate the relationship between selected gene polymorphisms and acute kidney injury after cardiac surgery. ⋯ The present findings support the hypothesis that ACE I/D and APO E gene polymorphisms may play a role in the development of acute kidney injury after cardiac surgery. However, AGTR1 does not have a unique association with postoperative renal impairment.
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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 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
Case ReportsA novel approach for off-pump atrial septostomy applications.
Atrial septostomy or septectomy are required to enable atrial mixture in various congenital cardiac lesions. The aim of this article was to introduce a technique where atrial septostomy application could be employed off pump with the aid of a new device. ⋯ We report the results of 7 patients for whom we employed our technique successfully using a new combined device as an alternative to traditional methods. The major advantage of our approach was avoiding detrimental effects of cardiopulmonary bypass applications.