Heart, Lung and Vessels

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

INTRODUCTION: This observational report depicts typical problems of extracorporeal membrane oxygenation cannulation from a large case series of a single center. METHODS: We analysed our experience with 720 consecutive patients receiving veno-venous or veno-arterial extracorporeal membrane oxygenation focusing on the spectrum of complications occurring in a subset of 159 patients treated with percutaneous veno-arteria extracorporeal membrane oxygenation in our institution between January 2009 to December 2014...

INTRODUCTION: Ultra-fast track anaesthesia aims at immediate extubation of cardiac surgical patients at the end of the operation. This study compares the effect of ultrafast track anesthesia versus continued postoperative mechanical ventilation on the intensive care unit length of stay. METHODS: Fifty-two elective adult patients were randomly allocated into ultrafast track anaesthesia and conventional groups by computer-generated random numbers. Redo operations, pre-operative intubation, uncontrolled diabetes, shock/left ventricular ejection fraction < 45%, pulmonary artery systolic pressure >55mmHg, creatinine clearance -1, haemodynamic instability, or those with concerns of postoperative bleeding were excluded...

INTRODUCTION: Reconstruction of the right ventricular outflow tract is the most commonly performed valve repair/replacement procedure in congenital cardiac surgery. There is an ongoing shortage of homografts, and existing bioprosthetic options suffer from substantial rates of structural valve deterioration over time. The Medtronic Freestyle valve is used extensively in the aortic position, but little data is available on its performance in the pulmonary position. METHODS: A systematic review and meta-analysis of primary studies reporting echocardiographic and clinical outcomes, including reintervention and functional status, associated with the Freestyle valve in the pulmonary position for both Ross and congenital surgery...

Fiberoptic bronchoscopy (for difficult intubation, bronchoalveolar lavage or biopsies), gastric endoscopies and transesophageal echocardiography (for transfemoral aortic valve replacement, MitraClip or left atrial appendage closure), are widespread diagnostic and therapeutic procedures. Non-invasive ventilation during upper endoscopies can be used to prevent or treat acute respiratory failure especially in high risk or sedated patients. We describe a novel full face mask specifically developed not only for "elective" non-invasive ventilation during upper endoscopies but also for emergent application without probe removal...

Even after incomplete myocardial recovery during mechanical circulatory support, long-term survival rates after ventricular assist device (VAD) explantation can be better than those expected after heart transplantation even for patients with chronic non-ischemic cardiomyopathy as the underlying cause for VAD implantation. The elective therapeutic use of ventricular assist devices for heart failure reversal in its early stage is a future goal. It may be possible to achieve it by developing tools to predict heart failure reversibility even before ventricular assist device implantation and increasing the number of weaning candidates by improvement of adjunctive therapies to optimize unloading-promoted recovery...

For selected patients ventricular assist device explantation is feasible. Freedom from heart transplantation and VAD support for >15 years following VAD removal is possible even if recovery is incomplete and the underlying cause for ventricular assist device implantation was a chronic form of cardiomyopathy. Echocardiography and rightheart catheterization are necessary to assess cardiac recovery. However, to date there is no gold standard for recovery assessment. Certain echocardiography parameters appeared highly predictive for long-term (≥5 years) post-weaning cardiac function and reliable for weaning decisions...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Intravenous immunoglobulin has been shown to decrease the risk of post-transplant infections in heart recipients with IgG hypogammaglobulinemia, however the use of subcutaneous immunoglobulin has not been reported. We report on immune reconstitution, clinical efficacy and tolerability of subcutaneous immunoglobulin replacement therapy in a heart transplant recipient with secondary antibody deficiency. Maintenance of IgG levels, specific antibodies and control of infections were observed after change from intravenous immunoglobulin to subcutaneous immunoglobulin due to poor intravenous access...

INTRODUCTION: Currently, the gold standard for donor organ preservation in clinical organ transplantation consists of 3 plastic bags and an ice box. The first plastic bag includes the organ itself immersed in preservation solution (e.g. Celsior). This bag is put in a second bag filled with saline, and then these two are put in a third bag filled with saline which is then put in the ice box.  The disadvantage of this method is that the organ usually gets too cold. It has been shown that the theoretical perfect temperature for organ preservation is 4°C - 8°C...

INTRODUCTION: Currently, a dose of protamine equal to 1 mg for each 100 units of heparin given is used to reverse the residual heparin activity following off-pump coronary artery bypass. We hypothesized that a 1:1 ratio (ratio of protamine to heparin) could be higher than necessary inducing post-operative disturbance of hemostasis. METHODS: Between January and March 2014 in 9 patients undergoing off-pump coronary artery bypass, we evaluated the effect of a dose of protamine equal to 1 mg per 100 units of heparin (Total Calculated Dose) on hemostasis as evaluated by means of thromboelastomery...

INTRODUCTION: Insufficient mesenteric perfusion is a dramatic complication in critically ill patients. Hydrogen sulfide, a newly recognized endogenous gaseous mediator, acts as an intestinal vasoactive agent and seems to protect against mesenteric ischemic damage. We investigated whether sodium hydrogen sulfide, a hydrogen sulfide donor, can improve mesenteric perfusion in an experimental model of pigs, both in physiological and ischemic conditions. METHODS: The study was conducted at Careggi University Hospital (Florence, IT)...