Objective: To evaluate intraoperative graft patency and identify grafts under risk of early occlusion.Methods: Fifty four patients were submitted to coronary artery bypass surgery and the graft flow was assessed by the Flowmeter (Medtronic Medistim), which utilizes the TTFM method. Three patients had left main disease and 48 had normal or mildly reduced left ventricular function.Results: In hospital mortality was 3.7% (two patients), one for mesenteric thrombosis and one due to cardiogenic chock. Seventeen patients (34%) were submitted to off pump CABG. Arterial Graft flow measures ranged from 8 to 106 ml/min (average 31.14 ml/min), and venous grafts flow ranged from 9 to 149 ml/min (average 50.42 ml/min).Conclusion: Flowmeter use represents higher safety both for patients and surgeons. Even under legal aspects, the documentation provided by the device can avoid future questionings. Bras Cir Cardiovasc 2012;27(3):401-4
Descriptors
Penetrating heart injuries present high mortality rates. Increasing rates of
urban violence have contributed to a significant rise in the number of heart
injuries by firearm projectiles. Such injuries are associated with the highest
mortality rates among penetrating cardiac injuries and may involve one or more
cardiac chambers. We present the case of a police officer who, in an approach to
five robbers, suffered a transfixed cardiac injury by firearm with the
projectile having been lodged inside the right ventricle. This patient was
successfully operated, 65 days after the injury, at our institution.
Constrictive pericarditis is a disease where loss of pericardial elasticity and restriction of filling of the cardiac chambers occurs. It is most often seen as an associated symptom of heart failure. Pericardiectomy provides effective treatment for patients with symptomatic constrictive pericarditis, although high rates of morbidity and mortality are related to the procedure. We present a case with extensive calcification, massive caseous necrosis and an important impairment of right ventricular function successfully operated in our institution.
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