Heart, lung & circulation
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Heart, lung & circulation · Apr 2012
Case ReportsExtra corporeal membrane oxygenation as right heart support following left ventricular assist device placement: a new cannulation technique.
Extracorporeal membrane oxygenation is an established treatment for acute respiratory failure, or low cardiac output syndrome. This can be veno-venous, in which de-oxygenated blood is drained from the venous system and oxygenated before being returned to the venous system, and veno-arterial where the re-oxygenated venous blood is returned to the arterial system. Haemorrhage, sepsis and thrombo-embolism are common and potentially lethal complications. ⋯ We report a successful case of right heart assist extra corporeal membrane oxygenation used as temporary right heart support in combination with a VentrAssist™ left ventricular assist device. The use of right heart assist extra corporeal membrane oxygenation to help a failing right heart during left ventricular assist device placement is not new, however, our technique describes a novel method of cannulation of the femoral vein and pulmonary trunk via a tunnelled vascular tube graft, which allows the chest to be closed whilst on right heart support, and decannulation to proceed without resternotomy. This technique has also been used successfully subsequent to this.
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Heart, lung & circulation · Apr 2012
Selective serotonin reuptake inhibitors, venlafaxine and duloxetine are associated with in hospital morbidity but not bleeding or late mortality after coronary artery bypass graft surgery.
No Australian study has reported the association between selective-serotonin reuptake inhibitor (SSRI) and serotonin noradrenaline reuptake inhibitor (SNRI) with coronary artery bypass graft (CABG) surgery morbidity and mortality. ⋯ SSRI/SNRI users experienced an increased risk of renal dysfunction and prolonged ventilation, but not bleeding events or long-term mortality after CABG surgery.