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PubMed1997

[Simultaneous coronary artery bypass grafting with other cardiovascular surgical procedures].

To improve the effect and reduce the mortality of the simultaneous coronary artery bypass grafting (CABG) with other cardiovascular surgical procedures, from Nov, 1984 to July, 1996, 51 patients underwent such operation. Among them 45 patients had valvular heart diseases, 4 postinfarction ventricular septal defect and ventricular aneurysm, and 1 myxoma of left atrium and abdominal aortal aneurysm. The operative mortality was 5.85% (3/51), and 3 patients died. Cardiovascular surgical patients of over 50 years or with angina pectorsi and ECG confirmed myocardiac ischemia should undergo coronary angiography routinely. If main coronary artery branches stenosis occupied over 50%, CABG must be performed. During the operation revasculariztion should be made as full as possible to enhance myocardiac protection and reduce the ascending aortic cross-clamping time.

Adolescent↗

PubMed1975

[Treatment of postoperative renal insufficiency after cardiovascular surgical procedures by peritoneal dialysis (author's transl)].

In 1972 and 1973 there have been 698 (351 with ECC) cardiovascular surgical procedures. 29 cases of renal insufficiency were seen in this group, 15 requiring peritoneal dialysis. There were only two survivors in the latter group. However none died due to renal insufficiency. The indication, technique, complications, results are discussed in detail.

Acute Kidney Injury↗

PubMed1999

[Role of transesophageal echocardiography in cardiovascular surgical procedures--special reference to the importance of cooperation between anesthesiologists and surgeons].

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Anesthesiology↗

PubMed2001

[Combined complex surgical procedures: cardiovascular and general surgery].

BACKGROUND: Aim of the paper is to evaluate the surgical indication in patients with cardiac and concomitant pathology. METHODS: In this study, are examined ten combined surgical sessions performed from 1992 at 1999, in patients affected by both cardiac and neoplastic disease with surgical indication. Eight men and two women, mean age 59.4 (range 50-68 years), eight affected by thoracic or abdominal tumour, one affected by hypersplenism and one by pulmonary cystic dysplasia with recurring pneumothorax. Anatomic resection and in two patient wedge-resection were performed except one woman who was splenectomized and one man who underwent atypical resection and pulmonary decortication. All subjects required extracorporeal circulation. RESULTS: No peri-operative deaths were observed and mean survival was 34 months (range 6-72 months). Moreover, there were no hemorrhages due to coagulation values of extracorporeal circulation. This approach proved useful both from the economic point of view and hospitalization time. CONCLUSIONS: According to personal experience this can be considered a successful therapeutic choice in selected patients. These observations suggest further considerations on combined operations surgery risk and mortality-morbidity appears to be reduced by a better myocardial revascularization.

Aged↗

PubMed2001

Predictive value of Candida colonization index in 131 patients undergoing two different cardiovascular surgical procedures.

BACKGROUND: Nosocomial candidemia is an important infection because of its increasing incidence and its high fatality rate. Candidiasis involves multiple risk factors. In this work, we study the degree of Candida colonization in cardiovascular surgical patients by taking into account the number of sites colonized and the density of growth. METHODS: Eleven (11) selected variables (age, sex, weight, diabetes, number of antibiotics, duration of antibiotics, length of hospitalization, length of stay in surgical intensive care unit, duration of surgery, temperature during surgery, and number of bypass) were considered to predict the perioperative variation of the colonization index (CI) by Candida in 131 cardiovascular surgical patients. These patients were divided into two groups: group A, coronary artery bypass grafting with extracorporeal circulation (72 patients) and group B, coronary artery bypass grafting without extracorporeal circulation (59 patients). RESULTS: One thousand and forty-eight fungal cultures were obtained from four different body sites and 162 isolated were identified. Candida albicans accounted for 74% of the strains in group A and 97% in group B. The statistical analysis (two-way anova) shows that group A patients with an increased CI have received significantly more antibiotics than those with a stable CI (1.50+/-0.83 vs 1.08+/- 0.40, p=0.0055). CONCLUSIONS: Epidemiological data obtained from this study show that coronary artery bypass grafting with extracorporeal circulation procedure is associated with an increase in the use of antibiotics and subsequently a higher risk a Candida colonization-infection.

Aged↗

PubMed1985

Phrenic nerve injury complicating closed cardiovascular surgical procedures for congenital heart disease.

Phrenic nerve injury (PNI) with resulting hemidiaphragmatic paralysis occurred in 19 (2.1 +/- 0.5%) of 891 closed cardiac surgical procedures during a twenty-three-year period. Diagnosis was confirmed by standard radiographic criteria. Phrenic nerve injury was most commonly noted following systemic-pulmonary artery anastomosis, ligation of persistent ductus arteriosus plus pulmonary artery banding, and atrial septectomy. Most patients were managed conservatively (nasotracheal or orotracheal intubation and positive end-expiratory pressure). Although no deaths were a direct result of PNI, major complications occurred in 15 of the 19 instances of PNI (79% +/- 10%). The serious morbidity and the hospital costs associated with this complication, however, underscore the cardinal importance of prevention. If injury does occur, early surgical intervention (diaphragmatic plication) in very young infants may reduce the attendant morbidity, but the complete role of diaphragmatic plication remains to be defined.

Adolescent↗

PubMed1952