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Heart Surgery Forum

Alexander T Booth, Patrick D Melmer, Benjamin Tribble, J Hunter Mehaffey, Curt Tribble
Vasoplegic syndrome is a form of vasodilatory shock that occurs frequently in patients who undergo cardiac surgery requiring cardiopulmonary bypass (CBP). Treatment often demands high doses of vasopressors over sustained periods for hypotension that can be refractory to standard vasoactive medications. Furthermore, the development of vasoplegia greatly contributes to morbidity and mortality following cardiac surgery. Methylene blue (MB) has become a popular therapy for cardiac vasoplegia despite a paucity of prospective data to direct its use...
October 31, 2017: Heart Surgery Forum
Shuyang Lu, Lai Wei, Jiayu Zheng, Chunsheng Wang
In this case report, we present the delayed diagnosis of an atypical partial anomalous pulmonary venous connection, which was initially misdiagnosed as primary pulmonary arterial hypertension. It was difficult to make a conclusive diagnosis using transthoracic echocardiography (TTE), because the two high right superior pulmonary veins drained into the superior vena cava and limited the shunt of patent foramen ovale. Preoperative TTE only showed right heart volume overload, pulmonary arterial hypertension, and severe tricuspid valve insufficiency...
October 31, 2017: Heart Surgery Forum
Franjo Rudman, Davor Baric, Danijel Unić, Igor Rudež
We read with great interest the report by Dr. Colak and coworkers about utilization of omentoplasty in poststernotomy mediastinitis treatment [Colak 2016]. In our opinion, several points need to be addressed.
October 31, 2017: Heart Surgery Forum
Cenk Conkbayir, Rezan Fahrioglu Yamaci, Pinar Gencer, Burc Barin, Genco Yucel, Cenk Eray Yildiz, Murat Ugurlucan, A Nazli Basak
BACKGROUND: The distribution of gene variants in the Turkish Cypriot population with coronary artery disease has not been investigated. In this study, we sought to research different genetic variants in the susceptibility to coronary artery disease and to identify possible associations between various clinical parameters and the genes involved in blood coagulation as well as glucose and lipid metabolism among the Turkish Cypriots and compared the results with the respective Turkish patients from Turkey...
October 30, 2017: Heart Surgery Forum
Curtis G Tribble
We came to The University of Virginia (UVA) within a year of each other nearly four decades ago: one (DN) to join the UVA basketball team during four of the best years of UVA basketball, and to earn 2 degrees, first in English and then in Sports Psychology; and the other (CT) to begin 7 years of training in general, vascular, thoracic, and cardiac surgery, which culminated with a faculty appointment in the UVA Department of Surgery, with part of the charge being to organize most of the Department's educational programs...
October 30, 2017: Heart Surgery Forum
Miha Antonic
BACKGROUND: Even minor postoperative reductions in renal function influence the outcome of cardiac surgery. The mechanisms of postoperative renal injury in cardiac surgery are multifactorial and include ischemia-reperfusion injury. The study investigates the effect of the antioxidant ascorbic acid on the postoperative acute kidney injury after elective CABG surgery. METHODS: A prospective randomized single-center trial was conducted in on-pump coronary artery bypass patients...
October 24, 2017: Heart Surgery Forum
Igor Rudez
October 24, 2017: Heart Surgery Forum
Ali Baran Budak, Kevin McCusker, Serdar Gunaydin
BACKGROUND: Despite the recent introduction of a number of technical and pharmacologic blood conservation measures, bleeding and allogeneic transfusion remain persistent problems in open-heart surgical procedures. Efforts should be made to decrease or completely avoid transfusions to avoid these negative reactions. METHODS: Our coronary artery bypass grafting database was reviewed retrospectively and a total of 243 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) were studied in a 12-month period (January-December 2016) after the implementation of the new program, and compared with 275 patients of the previous 12-month period...
October 24, 2017: Heart Surgery Forum
Hae Won Jung, Sung Yun Lee, Yoon Cheol Shin, Woo-Ik Chang, Jun Hyun Kim, Hye Ryeong Jo
A 50-year-old woman was referred to our hospital with a chief complaint of chest pain. Coronary angiography revealed a fistula between the left anterior descending artery and pulmonary artery with giant aneurysms. Although coronary angiography is considered the standard tool to confirm a coronary artery fistula, the patient in this case underwent successful surgical repair with the aid of multi-modality imaging.
October 24, 2017: Heart Surgery Forum
Tamer Ghazy, Utz Kappert, Ralf-Thorsten Hoffmann, Helena Hegelmann, Zuzana Fajfrova, Mohamed Eraqi, Klaus Matschke, Norbert Weiss, Adrian Mahlmann
BACKGROUND: Legitimacy of entry-oriented therapy for DeBakey I aortic dissection is of eminent importance in the era of emerging ascending aorta endovascular therapy. This study aims to evaluate early, midterm, and reintervention results of entry-oriented operative strategy compared to more aggressive strategies for treatment of DeBakey type I aortic dissection with an isolated intimal tear in the ascending aorta. METHODS: This study prospectively followed 98 consecutive patients who received an operation for DeBakey type I aortic dissection with the intimal tear in the ascending aorta between 2007 and 2013 for up to 6 years...
October 24, 2017: Heart Surgery Forum
Curtis G Tribble
There is a considerable amount of data that using more than one arterial graft provides a survival advantage for patients undergoing coronary bypass operations. The Society of Thoracic Surgeons has a set of official guidelines for the use of arterial grafts which include the following recommendations:Internal mammary arteries (IMA's) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated.As an adjunct to left internal mammary artery (LIMA), a second arterial graft (right IMA or radial artery [RA]) should be considered in appropriate patients...
August 28, 2017: Heart Surgery Forum
Xiao-Zu Liao, Zhi-Bin Zhou, Zhou Cheng, Xiao-Yu Yang, Xue Zhou, Bin-Fei Li, Xia Feng
BACKGROUND: Advances in ECMO have rapidly progressed in recent years; however, the clinical mortality rate remains high. This study aimed to identify the risk factors of ECMO in patients with cardiogenic shock. METHODS: Data of patients with cardiogenic shock who received ECMO from January 2006 to August 2013 at the Affiliated Hospital of Sun Yat-Sen University were retrospectively analyzed. All patients with cardiogenic shock were divided into two groups according to whether death occurred in the hospital...
August 28, 2017: Heart Surgery Forum
Graham Graham, Jeevan Kumar, Shinya Unai, Diehl T James, Hitoshi Hirose Md
BACKGROUND: A previous retrospective analysis of our cardiac surgery patients showed shortened ventilation time and hospital stay among patients receiving rigid sternal fixation compared to sternal wire fixation. We performed a prospective randomized study to further investigate these outcomes and determine if rigid closure can provide reduced pain after cardiac surgery. METHODS: Patients undergoing cardiac surgery between July 2011 and May 2014 were prospectively randomized into wire closure (Group C) or rigid fixation using sternal plates (Group R) groups...
August 28, 2017: Heart Surgery Forum
Amy G Fiedler, Thoralf M Sundt Iii, George Tolis
Mechanical complications following acute myocardial infarction are associated with high mortality. We present the first reported case of a new post myocardial infarction ventricular septal defect (VSD) within six months of coronary artery bypass grafting. The patient underwent successful surgical correction of the VSD with the assistance of mechanical circulatory support (MCS). This case highlights the importance of mechanical circulatory support in the management of cardiogenic shock associated with rare complications of myocardial infarction, even after surgical revascularization...
August 25, 2017: Heart Surgery Forum
Henna Elisa Sarja, Tuomas Anttila, Caius Mustonen, Hannu-Pekka Honkanen, Johanna Herajärvi, Henri Haapanen, Hannu Tuominen, Ilkka Miinalainen, Tatu Juvonen, Vesa Anttila
BACKGROUND: We hypothesized that diazoxide, a mitochondrial ATP-sensitive potassium channel opener, has cardioprotective effects during acute myocardial ischemia. Diazoxide is suggested to act through protein kinase Cε (PKCε) activation. METHODS: Twelve piglets were randomly assigned to receive intravenous infusion of diazoxide (3.5 mg/kg) with solvent or only solvent (6 animals per group) before cardiac ischemia. Myocardial ischemia was induced by occluding the left circumflex artery (LCX) for 40 minutes...
August 25, 2017: Heart Surgery Forum
Go Kusumoto, Kenji Shigematsu, Kouhei Iwashita, Kenji Tominaga, Takaaki Totoki, Ken Yamaura
BACKGROUND: Prophylactic use of intraaortic balloon pump (IABP) reduces hospital mortality in patients with left ventricular (LV) systolic dysfunction undergoing coronary artery bypass surgery (CABG); however, its association in patients with LV diastolic dysfunction is unclear. This retrospective study investigated the association between preoperative LV function and perioperative use of IABP in patients undergoing off-pump CABG (OPCAB) at a university hospital. METHODS: 100 consecutive patients who underwent OPCAB between January 1, 2011 and August 31, 2014 were studied...
August 25, 2017: Heart Surgery Forum
Fatih Ada, Kemalettin Ucanok, Ahmet Ruchan Akar, Mustafa Bahadir Inan, Serkan Durdu, Mustafa Sirlak, Levent Yazicioglu, Adnan Uysalel, Sadik Eryilmaz
BACKGROUND: Many of the previous studies on tricuspid valve surgery were on the materials that were used and the advantages and disadvantages of them. In this study, effects of preoperative tricuspid valve diameter on early postoperative outcomes were investigated. Methods: A total of 43 patients who underwent tricuspid valve repair surgery with the ring between the years 2012-2014 were included in this study. Tricuspid valve diameters and other cardiac functions of patients undergoing tricuspid intervention were evaluated with transthoracic echocardiography...
August 24, 2017: Heart Surgery Forum
Dusko Terzic, Emilija Nestorovic, Svetozar Putnik, Dejan Markovic, Miljko Ristic
BACKGROUND: Left ventricular assist devices (LVAD) have become a lifesaving solution for patients awaiting heart transplantation as well as an option to support the failing hearts of non-transplant candidates as a lifelong, or destination therapy (DT). Improvements in LVAD design have enabled greater durability and broader patient applicability, but not without complications. Ventricular arrhythmias in LVAD patients were considered benign in the early days of LVADs, but today are increasingly recognized for their harmful impact on morbidity and quality of life...
August 24, 2017: Heart Surgery Forum
Aws Alherbish, Colleen M Norris, Jay Shavadia, Mohammad Almutawa, Seraj Abualnaja, Jayan Nagendran, Michelle M Graham, Sean Van Diepen
BACKGROUND: Coronary artery bypass grafting (CABG) with multiple distal target (MDT) grafts requires less graft material and reduces cardiopulmonary bypass time; however, there may be a higher incidence of graft failure. A real-world analysis reporting long-term outcomes associated with MDT grafts is lacking. MATERIAL AND METHODS: In 6262 consecutive patients who underwent an isolated first CABG from 2004-2012, patients with MDTs were propensity matched to those with single distal target (SDT) grafts...
August 24, 2017: Heart Surgery Forum
Changhua Chen, Ching-Hui Huang, Ying-Chen Chen
Fungal endocarditis rarely occurs and is difficult to treat. Taguchi et al described that a 55-year-old man, who developed severe mitral regurgitation with persistent fungal infective endocarditis (IE) 8 months after coronary artery bypass grafting, was cured with mitral valve replacement via the anterolateral right thoracotomy without cross-clamping method [Taguchi 2016].
August 24, 2017: Heart Surgery Forum
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