The heart surgery forum
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The heart surgery forum · Jan 2005
Time and risk analysis for acute type A aortic dissection surgery performed by hypothermic circulatory arrest, cerebral perfusion, and open distal aortic anastomosis.
Hypothermic total circulatory arrest, retrograde or antegrade cerebral perfusion, and open distal anastomosis are important stages of surgical management and cerebral protection for acute type A dissections. Among the factors that influence survival are the transfer time to hospital from the onset of symptoms, in-hospital transfer time to operation, organ malperfusion, preoperative risk factors, and intraoperative variables. The aim of this study was to analyze time and risk factors during surgical management. ⋯ Total circulatory arrest, cerebral perfusion, and open distal anastomosis are reliable options in the surgical management of acute type A aortic dissections. With open distal anastomosis aortic arcus can be evaluated, distal anastomosis can be performed more easily, and postoperative neurological recovery is hastened. In the present study, although statistical significance could not be reached due to limited sample size, the time to admission, durations of total circulatory arrest, cross-clamp, and cardiopulmonary bypass, and the amount of postoperative chest output seem to influence postoperative survival.
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The heart surgery forum · Jan 2005
Case ReportsClosure of secundum atrial septal defect with autologous right atrial patch: case report.
Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. ⋯ Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.
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Fast-track recovery protocols result in shorter hospital stays and decreased costs in coronary artery bypass grafting (CABG) surgery. However, data based on an objective scoring system are lacking for the impact of these protocols on patients undergoing cardiac surgery other than isolated CABG. ⋯ This study confirms the safety and efficacy of the fast-track recovery protocol in patients undergoing open cardiac surgery other than isolated CABG.
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The heart surgery forum · Jan 2005
Ongoing procedure development in robotically assisted totally endoscopic coronary artery bypass grafting (TECAB).
Totally endoscopic coronary artery bypass grafting (TECAB) using robotics requires stepwise introduction into a heart surgery program. It is the aim of this study to evaluate the state of procedure development after continued application of telemanipulation techniques in the clinical setting. We also sought to assess perioperative and intermediate term clinical results after robotically assisted CABG. ⋯ We conclude that despite being surgically challenging robotically assisted coronary artery surgery can be implemented with acceptable safety. TECAB procedures have reached a reproducible state. Perioperative mortality after robotically assisted CABG may be lower than predicted. Intermediate term clinical results are very satisfactory.
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The heart surgery forum · Jul 2004
Clinical TrialCalculated reduction aortoplasty for dilatation of the ascending aorta associated with aortic valve replacement.
Previous studies have advocated reduction aortoplasty to normalize the diameter of a moderately dilated ascending aorta associated with aortic valve disease. One of the reported techniques is the shawl lapel aortoplasty, which we have adopted and modified by setting a simple set of calculations. We present our midterm results. ⋯ The shawl lapel technique based on simple calculations, used as a diameter-reduction strategy for ascending aortic dilatation encountered during aortic valve replacement, is an efficacious method with excellent medium-term results.