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Tranexamic Acid Versus ɛ-Aminocaproic Acid: Efficacy and Safety in Pediatric Cardiac Surgery
OBJECTIVE: Tranexamic acid (TXA) and ɛ-aminocaproic acid (EACA) are used for antifibrinolytic therapy in cardiac surgery, although data directly comparing their blood sparing effect and their side effects, especially in paediatric cardiac surgical patients, are still missing. METHODS: We analysed perioperative data of 234 paediatric patients weighing less than 20 kg undergoing cardiac surgery. In a 5-month period,…
Investigation and Evaluation of Potential Aerosol Release by Maquet/Getinge Heater-Cooler Units Used during Cardiac Surgery
Heater-Cooler units (HCUs) supply tempered water through blood heat exchangers and through warming/cooling blankets to control the body temperature of heart surgery patients.
Comparative Study Between Different Modes of Ventilation During Cardiopulmonary Bypass and its Effect on Postoperative Pulmonary Dysfunction
BACKGROUND: Postoperative pulmonary dysfunction is a prevalent complication after cardiac surgery; it has many contributing considerations due to either the surgery itself, anomalies to gas exchange or maybe as a result of alterations in lung mechanics. The aim of this study was to compare pressure-controlled ventilation versus volume-controlled ventilation in the presence of no ventilation…
Minimally Invasive Biventricular Mechanical Circulatory Support With Impella Pumps as a Bridge to Heart Transplantation
Abstract Cardiogenic shock from biventricular failure that requires acute mechanical circulatory support carries high 30 day mortality. Acute mechanical circulatory support can serve as bridge to orthotopic heart transplant (OHT) in selected patients. We report a patient with biventricular failure secondary to rapidly progressive cardiac sarcoidosis refractory to medical management who was bridged to OHT…
Impella Versus IABP in Acute Myocardial Infarction Complicated by Cardiogenic Shock.
OBJECTIVE: We investigated the benefit of Impella, a modern percutaneous mechanical support (pMCS) device, versus former standard intra-aortic balloon pump (IABP) in acute myocardial infarction complicated by cardiogenic shock (AMICS). METHODS: This single-centre, retrospective study included patients with AMICS receiving pMCS with either Impella or IABP. Disease severity at baseline was assessed with the IABP-SHOCK II score. The…
Single-Dose Cardioplegia Protects Myocardium as Well as Traditional Repetitive Dosing: A Noninferiority Randomized Study
The present prospective noninferiority randomized trial was designed to demonstrate the safety and efficacy of a single dose of Custodiol histidine-tryptophan-ketoglutarate compared with repetitive cold-blood cardioplegia.
Cost-Effectiveness of Left Atrial Appendage Closure for Stroke Reduction in Atrial Fibrillation: Analysis of Pooled, 5-Year, Long-Term Data
Recent publications reached conflicting conclusions about the cost-effectiveness of left atrial appendage closure (LAAC) with the Watchman device (Boston Scientific, Marlborough, MA) for stroke risk reduction in nonvalvular atrial fibrillation (AF).
A Systematic Review and Meta-Analysis of Bivalirudin Application in Peripheral Endovascular Procedures
The direct thrombin inhibitor bivalirudin (BIV) was shown to be superior to unfractionated heparin (UFH) in percutaneous coronary interventions for reducing procedural blood loss. The aim of this study was to compare outcome profiles of BIV and UFH in peripheral endovascular procedures (PEPs) by synthesizing the currently available data.
Thromboelastography and Thromboelastometry in Assessment of Fibrinogen Deficiency and Prediction for Transfusion Requirement: A Descriptive Review
Both Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) have been increasingly used to diagnose fibrinogen deficiency and guide fibrinogen transfusion in trauma and surgical bleeding patients.
Why Does A Point Of Care Guided Transfusion Algorithm Not Improve Blood Loss and Transfusion Practice in Patients Undergoing High-Risk Cardiac Surgery? A Prospective Randomized Controlled Pilot Study
Timely diagnostic and goal-directed therapies aim at the reduction of bleeding and need for allogeneic transfusions.
Utility of Thromboelastography versus Routine Coagulation Tests for Assessment of Hypocoagulable State in Patients Undergoing Cardiac Bypass Surgery
This study was done to evaluate usefulness of Thromboelastography (TEG) and routine coagulation tests (RCT) in assessing hemostatic changes and predicting postoperative bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass.
Production Standard and Stability of Compounded Del Nido Cardioplegia Solution
This report defines in-house production standards, as well as the stability of del Nido cardioplegia solution (dNCS) under optimal storage conditions.
Impact of Ultrafiltration on Kidney Injury After Cardiac Surgery: The Michigan Experience
This study examines the relationship between the use and volume of conventional ultrafiltration (CUF) and the risk of acute kidney injury (AKI) after isolated on-pump coronary artery bypass graft surgery.
The Effect of Ultrafiltration on End-Cardiopulmonary Bypass Hematocrit During Cardiac Surgery
OBJECTIVE: Ultrafiltration (UF) during cardiopulmonary bypass (CPB) is a well-accepted method for hemoconcentration to reduce excess fluid and increase hematocrit, platelet count and plasma constituents. The efficacy of this technique may confer specific benefit to certain patients presenting with acquired cardiac defects. The purpose of this study was to retrospectively evaluate the effect of UF on…
The Prognosis Impact of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Plus Cytoreductive Surgery (CRS) in Advanced Ovarian Cancer: The Meta-Analysis
Background and Objective Previous studies about the prognostic value of the HIPEC have yielded controversial results. Therefore, this study aims to assess the impact of HIPEC on patients with ovarian cancer. Results We included 13 comparative studies, and found that the overall survival (OS) and progression-free survival (PFS) in HIPEC groups were superior to groups…
The Complexity of Atrial Fibrillation Newly Diagnosed After Ischemic Stroke and Transient Ischemic Attack: Advances and Uncertainties
Purpose of Review Atrial fibrillation is being increasingly diagnosed after ischemic stroke and transient ischemic attack (TIA). Patient characteristics, frequency and duration of paroxysms, and the risk of recurrent ischemic stroke associated with atrial fibrillation detected after stroke and TIA (AFDAS) may differ from atrial fibrillation already known before stroke occurrence. We aim to summarize…
Calcium in the Pathophysiology of Atrial Fibrillation and Heart Failure
Atrial fibrillation (AF) is commonly associated with heart failure. A bidirectional relationship exists between the two—AF exacerbates heart failure causing a significant increase in heart failure symptoms, admissions to hospital and cardiovascular death, while pathological remodeling of the atria as a result of heart failure increases the risk of AF. A comprehensive understanding of the…
Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group
Acute kidney injury (AKI) occurs in 7% to 18% of hospitalized patients and complicates the course of 50% to 60% of those admitted to the intensive care unit, carrying both significant mortality and morbidity. Even though many cases of AKI are reversible within days to weeks of occurrence, data from multiple large observational and epidemiological…
The Pivotal Role of Imaging in TAVR Procedures
This review presents currently important aspects of TAVR imaging, describing the salient features of each modality as well as recent developments in the field.
Effect of Ultrafiltration on Extravascular Lung Water Assessed by Lung Ultrasound in Children Undergoing Cardiac Surgery: A Randomized Prospective Study
Ultrafiltration has been shown to decrease total body water and postoperative blood loss and improve the alveolar to arterial oxygen gradient and pulmonary compliance. This study investigated whether conventional ultrafiltration during CPB in paediatric heart surgeries influences post-bypass extravascular lung water (EVLW) assessed by lung ultrasound (LUS).
Sedation Effects by Dexmedetomidine Versus Propofol in Decreasing Duration of Mechanical Ventilation After Open Heart Surgery
The objective of this study was to compare the suitability (efficacy and safety) of dexmedetomidine versus propofol for patients admitted to the intensive care unit (ICU) after the cardiovascular surgery for the postoperative sedation before weaning from mechanical ventilation.
Simulation-Based Training in Cardiac Surgery
This study hypothesized that some skills could be learned efficiently and safely by using simulation with component task training, deliberate practice, progressive complexity, and experienced coaching to produce safer cardiac surgeons.
Comparison of Three Infant Venous Reservoirs with Vacuum-Assisted Venous Drainage During Varying Levels of Cardiotomy Suction
A comparison of three different infant hard-shell venous reservoirs also took place to determine if one reservoir type was more advantageous when handling cardiotomy suction.
Mechanical Ventilation Management during ECMO for ARDS: An International Multicenter Prospective Cohort
To report current practices regarding mechanical ventilation in patients treated with extracorporeal membrane oxygenation(ECMO) for severe acute respiratory distress syndrome (ARDS) and their association with 6-month outcomes.