Subject(s)
Mycoses/complications , Saccharomyces boulardii , Shock, Septic/microbiology , Adult , Female , HumansABSTRACT
OBJECTIVES: Ageing of the surgical population and the evolution in anaesthetic techniques have led the Club d'anesthésie-réanimation et techniques en chirurgie cardiaque (ARTECC) to conduct a survey among French cardiac surgery centers. The aim was to profile patient population undergoing cardiac surgery and perioperative techniques employed. STUDY: National prospective study including all adult patients undergoing cardiac surgery on January 23rd, 24th and 25th, 2001. Data were collected during the first 48 postoperative hours. MATERIAL AND METHODS: Seven referent centers drafted a record form. Sixty-one centers sent back 425 patient forms, 399 were analyzed. The following were statistically studied: type of surgery, patient characteristics, preoperative treatment, monitoring, anaesthesia, cardio-pulmonary bypass (CPB) characteristics, duration of mechanical ventilation, length of stay in intensive care unit, postoperative complications. RESULTS: Patient mean age was 64.3 +/- 13.3 years. Patients over 80-year-old represented 2.5% of the population. Beating heart coronary aortic bypass grafts (13% surgery) and preoperative transoesophagal echography were not frequent. Propofol and sufentanil were the main anaesthetic agents used. There was a marked trend for fast-track procedures. CONCLUSIONS: The ARTECC study pointed out some reserve in practices and that the impact of new techniques seems limited. Regular use of studies of that kind will provide an effective tool to compare national practices.
Subject(s)
Anesthesia/trends , Cardiac Surgical Procedures/trends , Critical Care/trends , Adult , Aged , Aged, 80 and over , Anesthetics , Appointments and Schedules , Cardiopulmonary Bypass/statistics & numerical data , Data Collection , Female , France/epidemiology , Humans , Intensive Care Units , Length of Stay , Male , Middle Aged , Monitoring, Physiologic , Patients , Postoperative Care , Postoperative Complications/epidemiology , Preoperative Care/trends , Prospective Studies , Respiration, ArtificialABSTRACT
A report is presented of a 31 year female patient with Ehlers-Danlos syndrome type IV who presented a bilateral renal artery dissection and a hematoma of the ascending aorta simultaneously. She had had an uneventful delivery six months before. We also discovered a situs solitus with dextrocardia in this patient. These complications were managed conservatively. Unfortunately the patient died of a pulmonary infection and a multi-organ failure syndrome several days after her admission.
Subject(s)
Aortic Dissection/diagnosis , Dextrocardia/diagnosis , Ehlers-Danlos Syndrome/diagnosis , Renal Artery , Adult , Aortic Dissection/diagnostic imaging , Aortic Diseases/diagnostic imaging , Dextrocardia/diagnostic imaging , Ehlers-Danlos Syndrome/complications , Fatal Outcome , Female , Hematoma/diagnostic imaging , Humans , Radiography , Renal Artery/diagnostic imaging , UltrasonographyABSTRACT
Fifty eight patients underwent emergency thoracic aortic surgery over a nine year period (Nov 80 Nov 89). Two pathologies may be opposed with regard to etiology, circumstances and patients. Traumatic aortic ruptures (18): the most common location of the tear was at the isthmus of aorta (18). They occurred in a violent crash and often affected young patients. Early treatment gave a good prognosis, outcome depending on other lesions. Others (40) were descending aortic aneurismal fissure, ascending aortic dissection and compound type B dissection (ischemic form or breaking point). These affected an older population with an important cardio-vascular risk. This high risk population combined with an open chest surgery with or without extracorporeal circulation aggravated the prognosis.
