1,720,977 research outputs found
Reconstruction of Extrapericardial Rupture of Inferior Vena Cava Without Cardiopulmonary Bypass Due to Blunt Trauma
No full textTurning Things Around: The Role of Prone Positioning in the Management of Acute Respiratory Failure After Cardiac Surgery
No full textSafety and efficacy of digital chest drainage units compared to conventional chest drainage units in cardiac surgery
No full textDesign and training effects of a physical reality simulator for minimally invasive mitral valve surgery
No full textDiagnostic Value of Cholinesterase Activity for the Development of Postoperative Delirium after Cardiac Surgery
No full textComplex Valve Surgery in Elderly Patients: Increasingly Necessary and Surprisingly Feasible
No full textAneurysm of the Pulmonary Vein: An Unusual Cause of Stroke
No full textThis clinical report deals with a giant true pulmonary venous aneurysm, which was partially thrombosed. The overall incidence of pulmonary venous aneurysms is unknown, and they are reported only occasionally. We present the case of a previously healthy man with acute onset of ischemic cerebral stroke. The cause was a thrombus in a huge aneurysm of the left superior pulmonary vein. The patient subsequently underwent uncomplicated therapy for stroke, including thrombolysis followed by excision of the giant pulmonary venous aneurysm. As curative therapy we recommend complete resection of this rare entity. (C) 2014 by The Society of Thoracic Surgeon
Is there a correlation between late re-exploration after cardiac surgery and removal of epicardial pacemaker wires?
Full text linkRe-exploration for bleeding accounts for increased morbidity and mortality after major cardiac operations. The use of temporary epicardial pacemaker wires is a common procedure at many departments. The removal of these wires postoperatively can potentially lead to a serious bleeding necessitating intervention. From Jan 2011 till Dec 2015 a total of 4244 major cardiac procedures were carried out at our department. We used temporary epicardial pacemaker wires in all cases. We collected all re-explorations for bleeding and pericardial tamponade from our surgical database and then we focused on the late re-explorations, meaning on the 4th postoperative day and thereafter, trying to identify the removal of the temporary pacemakerwires as the definite cause of bleeding. Patients’ records and medication were examined. Thirty-nine late re-explorations for bleeding, consisting of repeat sternotomies, thoracotomies and subxiphoid pericardial drainages, were gathered. Eight patients had an acute bleeding incidence after removal ofthe temporary wires (0.18%). In four of these patients, a pericardial drainage was inserted, whereas the remaining patients were re-explorated through a repeat sternotomy. Two patients died of the acute pericardial tamponade,three had a blood transfusion and one had a wound infection. Seven out of eight patients were either on dualantiplatelet therapy or on combination of aspirin and vitamin K antagonist. A need for re-exploration due to removal of the temporary pacemaker wires is a very rare complication, which however increases morbidity and mortality. Adjustment of the postoperative anticoagulation therapy at the time of removal of the wires could further minimize or even prevent this serious complication
NGAL expression during cardiopulmonary bypass does not predict severity of postoperative acute kidney injury
No full textBackground: Renal injury is a serious complication after cardiac surgery and therefore, early detection and much more prediction of postoperative kidney injury is desirable. Neutrophil gelatinase-associated lipocalin (NGAL) is a predictive biomarker of acute kidney injury and may increase after cardiopulmonary bypass (CPB). However, time correlation of NGAL expression and severity of renal injury is still unclear. The aim of our study was to investigate CPB-related urine NGAL (uNGAL) secretion in correlation to postoperative renal function. Methods: Data of NGAL expression along with clinical data of 81 patients (52 male and 29 female) were included in this study. Mean age of the patients was 66.8 +/- 12.8 years. Urine NGAL was measured at seven time points (T-0: baseline; T-1: start CPB, T-2: 40 min on CPB; T-3: 80 min on CPB; T-4: 120 min on CPB; T-p1: 15 min after CPB; T-p2: 4 h after admission to the intensive care unit) and renal function in the postoperative period was classified daily according to Acute Kidney Injury Network (Ronco et al, Int J Artif Organs 30(5): 373-6) criteria (AKIN). Results: Expression of uNGAL increased at T-4 (120 min on CPB) and post-CPB (T-p1 and T-p2; p < 0.01 vs. baseline) but there was no correlation between uNGAL level and duration of CPB nor between uNGAL expression and occurrence of postoperative kidney injury. The renal function over 10 days after surgery remained normal in 50 patients (AKIN level 0), 18 patients (22%) developed mild and insignificant renal injury (AKIN level 1), eight patients (10%) developed moderate renal failure (AKIN level 2), and five patients (6%) severe kidney failure (AKIN level 3). Twenty-four out of 31 patients developed renal failure within the first 48 h after surgery. However, there was no correlation between uNGAL expression and severity of acute renal failure. Conclusion: Although uNGAL expression increased after CPB, the peak values neither predict acute postoperative kidney injury, nor severity of the injury
- …
