Abdominal procedures are suggested to be done with cardiac surgery at the same time with laparoscopic technique to reduce mortality and morbidity in these patients.
Fatores de risco que afetam as complicações da dissecação da veia safena na revascularização cirúrgica do miocárdioThe risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery Abstract Objective: Problem of wound healing is commonly observed after coronary artery bypass graft procedures. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complication after coronary revascularization procedures.Methods: After institutional ethical committee review and approval, a retrospective review was undertaken of 4029 bypass procedures with saphenous vein graft performed over a period of six years is conducted. Thirteen risk factors for those who developed major leg wound complications were analyzed and compared with the entire cohort of patients, undergoing similar bypass procedures during the same period.Results: Lower extremity wound complications occurred in 68 patients (1.7%), 43 of them required additional surgical interventions. There were 17 wound debridements, nine skin grafts, one angioplasty, 11 fasciotomies, three vascular procedures, and two free tissue transfers. Of 13 variables evaluated by multivariate analysis, female gender, BMI, use of internal thoracic artery graft, peripheral vascular disease, the use of postoperative intraaortic balloon pump and preexisting hyperlipidemia were identified as significant independent predictors of major leg wound complications (p<0.05).Conclusions: Rev Bras Cir Cardiovasc 2008; 23(3): 317-322
IntroductionAortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse.Case PresentationA 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse. He was admitted to the emergency department of the hospital, and was then transferred to the cardiac care unit to control the chest pain. The patient underwent emergent surgery. After induction of anesthesia, tranesophageal echocardiography probe was introduced gently and a full exam was done. The surgeon decided to perform a classic Bentall procedure. Cardiopulmonary bypass was started. Everything was acceptable, but bleeding was uncontrolled. The surgical team could not control the bleeding, and he passed away due to bleeding.ConclusionsThis case report stresses the use of IOTEE as a means for more accurate diagnosis of the lesion under general anesthesia, especially when there is not time to do preoperative TEE, or when bedside echocardiography does not give us adequate data.
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