In this study, we showed that on-pump beating heart operations without cross-clamping is an acceptable surgical choice for mitral valve disease. Complication rates are low and perioperative mortality is lower than that generally reported with conventional technique.
Levosimendan exhibits an important protection by means of neurological outcome, histopathological, and biochemical analysis for the ischemia-reperfusion injury of the spinal cord following the aortic clamping.
The vasodilating efficacy of levosimendan and its relaxation mechanism differs between the arteries from males and females, which may have clinical consequences in the treatment of heart failure.
On-pump beating heart aortic valve replacement with retrograde CS warm blood perfusion is a good surgical option, and has the advantage of maintaining physiologic condition of the heart throughout the procedure.
Background: Acute Stanford type A aortic dissection (ATAAD) is a life-threatening medical emergency. The aim of this study was to investigate the clinical significance of the prognostic nutritional index (PNI) as a novel inflammatory marker for ATAAD patients undergoing surgical repair. Methods: We retrospectively examined the medical records of 151 ATAAD patients who treated surgically. Patients were divided into two groups (survival and death) and these groups were compared with respect to clinical and laboratory parameters. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). Logistic regression analyses were performed to identify the risk factors of in-hospital mortality. Results: The mean age of the study cohort was 61 ± 12 years, 99 (65.6%) were males, and 35 (23.2%) patients died during the hospital stay. The PNI levels were significantly lower in death group compared with survival group (32.80 ± 4.90 vs. 37.94 ± 5.42, p < 0.001). Multivariate analysis showed that the PNI (OR: 0.795, p = 0.005), age (odds ratio [OR]: 1.085, p = 0.034), operating time (OR: 1.660, p = 0.042), and D-dimer (OR: 1.002, p = 0.001) independently predicted in-hospital mortality. The calculated cutoff value of the PNI was 33.01. Conclusion: Lower PNI values are independently associated with in-hospital mortality in ATAAD. The PNI may be a useful tool for predicting the early mortality of ATAAD patients after surgical repair.
Closure of post myocardial infarction ventricular septal defect with this technique offers an alternative and safe approach to repair of the residual VSD when the coronary bypass grafts are patent.
Bleeding due to dense adhesions between the epicardium and the sternum may be encountered during subxiphoid drainage for postoperative late cardiac tamponade and lead to a 3 % mortality rate.
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