Heart, lung & circulation
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Heart, lung & circulation · Jul 2011
ReviewFocused clinical review: periprocedural management of antiplatelet therapy in patients with coronary stents.
Coronary stent implantation, particularly drug eluting stents, is now the major method of coronary revascularisation. Following drug-eluting stent implantation dual antiplatelet therapy with aspirin and thienopyridine is recommended for at least 12 months. ⋯ Late (>30 days) and very late (>365 days) stent thrombosis appears to more common with DES and poses the questions of when is it safe to stop antiplatelet therapy post coronary stenting and how to manage patients who need non-cardiac surgery. This article reviews the evidence for stent thrombosis and the peri-operative management of patients with coronary stents and provides an algorithm for patient management based on multidisciplinary assessment of bleeding risk, perioperative cardiac event and stent thrombosis risk.
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Heart, lung & circulation · Jul 2011
Case ReportsPenetrating cardiac injury following sewing needle ingestion.
Penetrating cardiac injuries are common in South Africa. Reports describing traumatic lesions to the heart caused by caudo-cranial migration of ingested foreign bodies are however extremely rare. ⋯ We present the case of a 19 year-old man who sustained a left ventricular injury after intentionally swallowing eight sewing needles. The impacted needle was removed through a median sternotomy and the patient recovered uneventfully.
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Heart, lung & circulation · Jul 2011
Five-year analysis of operative mortality and neonatal outcomes in congenital heart disease.
We sought to compare overall mortality with neonatal outcomes over a five year period to define risk factors for mortality and service development priorities. ⋯ This study provides an accurate and contemporary audit of mortality risk associated with congenital heart surgery. Outcomes compare favourably to international benchmarks but highlight the risks of morbidity and mortality associated with neonatal cardiac surgery.