The heart surgery forum
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The heart surgery forum · Jan 2007
Preoperative fibrinogen levels as a predictor of postoperative bleeding after open heart surgery.
Open heart surgery still involving major bleeding continues to be a major challenge after cardiac surgery and is also a significant cause of morbidity and mortality. Most hemostatic factors are intercorrelated with postoperative bleeding, and fibrinogen seems the most fundamental hemostatic risk factor for open heart surgery. ⋯ The results of this study suggested that low preoperative fibrinogen level appears to be a useful diagnostic marker to assess the activity of the coagulation system, and that its preoperative level may serve as a potential risk factor for postoperative bleeding after coronary artery bypass surgery.
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The heart surgery forum · Jan 2007
Cardiac surgery after heart transplantation: coronary artery bypass grafting and heart valve replacement.
Due to increasing need for and a shortage of donor organs, therapeutic procedures such as heart valve replacement for valve insufficiency and coronary artery bypass grafting (CABG) for graft vasculopathy (GVP) must be performed to improve allograft function to avoid retransplantation. ⋯ Cardiac surgical procedures can be safely performed after heart transplantation. To improve graft and patient survival, such procedures must be carefully performed after heart transplantation to avoid retransplantation. The shortage of donor organs will and must lead to an increase in the number of conventional procedures performed to improve allograft function in transplanted hearts.
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The heart surgery forum · Jan 2007
Case ReportsAorto-innominate fistula by gun-shot injury: a case report.
We report an aorto-innominate fistula caused by gun-shot injury. The fistula was diagnosed by aortography and repaired under hypothermic circulatory arrest.
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The heart surgery forum · Jan 2007
How I do it: traction of ascending aorta with starfish heart positioner during proximal saphenous vein graft anastomosis using the PAS-Port system in off-pump coronary artery bypass grafting.
The PAS-Port system allows for the rapid deployment of a clampless proximal anastomosis between a saphenous vein graft and the aorta. We have developed a simple technique of establishing traction of the ascending aorta with the Starfish heart positioner during proximal saphenous vein anastomosis using the PAS-Port system in off-pump coronary artery bypass grafting.
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The heart surgery forum · Jan 2007
Predictive risk factors for early mortality in operative treatment for chronic ischemic mitral insufficiency.
The combination of coronary artery bypass grafting and mitral valve surgeries is closely associated with high in-hospital mortality and morbidity. In this study, we sought to analyze the factors that influence early mortality in 68 patients undergoing coronary artery bypass grafting + mitral valve surgery due to ischemic mitral insufficiency. ⋯ The early mortality rate was found to be 13.2% (9/68) in patients with ischemic mitral regurgitation undergoing simultaneous coronary bypass and mitral valve surgeries. New York Heart Association class > or =3, left ventricle end-systolic volume, left ventricle end-systolic diameter, cardiopulmonary perfusion time, preoperative unstable angina pectoris, intra-aortic balloon application, and age >65 years were determined to be statistically significant risk factors that influence early in-hospital mortality.Conclusion. Surgery, despite having a high mortality risk in patients with ischemic mitral insufficiency, is considered to be a treatment measure that generally improves the quality of life and prolongs life.