Heart, lung & circulation
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Heart, lung & circulation · Apr 2008
Randomized Controlled TrialSupervised moderate intensity exercise improves distance walked at hospital discharge following coronary artery bypass graft surgery--a randomised controlled trial.
This study aimed to determine whether a structured, inpatient (or Phase 1 cardiac rehabilitation), physiotherapy-supervised walking program, with or without musculoskeletal and respiratory exercises, might improve walking capacity and other parameters for patients undergoing coronary artery bypass graft surgery (CABG). ⋯ A physiotherapy-supervised, moderate intensity walking program in the inpatient phase following CABG improves walking capacity at discharge from hospital. The performance of respiratory and musculoskeletal exercises confers no additional benefit to the measured outcomes.
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Heart, lung & circulation · Apr 2008
Case ReportsAcute pulmonary thromboembolism during mitral valve repair.
Perioperative pulmonary thromboembolism during cardiac surgery is extremely rare. We report a 55-year-old male, who developed acute pulmonary thromboembolism during mitral valve repair. ⋯ The diagnostic accuracy and sensitivity of transoesophageal echocardiography in circumstances with altered haemodynamics is questionable and has not been investigated. Therefore, indirect evidence of pulmonary artery obstruction on echocardiography may have a predictive value and failure to demonstrate pulmonary thromboembolism by this tool should not exclude the possibility of it especially when it is highly suspected.
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Heart, lung & circulation · Apr 2008
Case ReportsNo air leak on PPV does not exclude tracheobronchial injury after blunt chest trauma.
Tracheobronchial injuries are commonly associated with persistent air leak with pneumothoraces especially when on positive pressure ventilation (PPV). Injuries with absence of these features together with collapse of the lung and consequent low arterial oxygen tension while on PPV are less well recognised. We present a patient with traumatic aortic dissection and preoperatively undiagnosed complete transaction of the left main bronchus following blunt chest trauma. He had no persistent air leak with lower lung lobe collapse despite undergoing PPV and had low arterial oxygen tension which failed to respond to appropriate oxygen therapy.
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Heart, lung & circulation · Feb 2008
Modified Blalock-Taussig shunt: immediate and short-term follow-up results in neonates.
The modified Blalock-Taussig shunt (MBTS) is the most commonly created systemic-pulmonary shunt in neonates with cyanotic heart disease. Morbidity and mortality after MBTS is associated with several factors including age, pulmonary artery diameter and the baseline cardiac anatomy. The objective of this research was to describe the immediate and short-term follow-up results of MBTS in Pakistani neonates. ⋯ The mortality rate in neonates is highest during the first post-operative month. Shunt thrombosis and occlusion can be sudden and fatal therefore coagulation profile should be carefully monitored especially in the peri-operative period. PA-IVS was the most common anatomical variant in our limited experience and had high morbidity and mortality rate after surgery.
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Heart, lung & circulation · Feb 2008
Randomized Controlled Trial Comparative StudyA randomised study of three different informational AIDS prior to coronary angiography, measuring patient recall, satisfaction and anxiety.
Informed consent is a basic standard of care for all patients undergoing medical procedures, but recall of information has been shown to be poor. We sought to compare verbal, written and animated audiovisual information delivery, during consent for coronary angiography, by measuring improvement in recall. ⋯ Despite careful design of an innovative audiovisual delivery technique aimed at optimising comprehension and aiding memory, recall of information was poor and informational aids showed no improvement. Modes of information delivery are not the key to patient assimilation of complex medical information.