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1.
J Cardiovasc Surg (Torino) ; 51(6): 935-9, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21124292

ABSTRACT

AIM: This study evaluated the effect of pleurotomy on respiratory system compliance and resistance in off-pump coronary artery bypass (OPCAB) using the left internal thoracic artery (LITA). METHODS: Thirty-two patients were prospectively allocated into two groups: OP group (n = 16 patients with open left pleural cavity); IP group (N.=16 patients with intact pleural cavity). Static and dynamic lung compliance and total respiratory system resistance calculation were recorded at anesthesia induction (before chest opening) and immediately after chest closure. RESULTS: Static lung compliance values significantly decreased after chest closure in both groups (P < 0.0001), but the OP group had a significantly greater decline (P = 0.0007). Dynamic lung compliance decreased in either groups after chest closure (P < 0.0001), however, no significant difference was found between groups (P = 0.228). Total respiratory system resistance increased in both groups (P < 0.05), however the OP group had a higher increase (P = 0.0005). Orotracheal intubation time (P = 0.041) and hospital stay (P = 0.0004) were higher in the OP group. CONCLUSION: Pleura opening and need of chest tube insertion induced significant reduction in static lung compliance and increase in total respiratory system resistance, furthermore contributing to impair pulmonary dysfunction in the early postoperative period after OPCAB.


Subject(s)
Airway Resistance , Coronary Artery Bypass, Off-Pump/adverse effects , Lung Compliance , Lung Diseases/etiology , Pleura/surgery , Adult , Aged , Brazil , Chi-Square Distribution , Female , Humans , Intubation, Intratracheal , Length of Stay , Lung Diseases/physiopathology , Male , Middle Aged , Prospective Studies , Time Factors , Treatment Outcome
4.
Eur J Cardiothorac Surg ; 3(5): 408-13, 1989.
Article in English | MEDLINE | ID: mdl-2699809

ABSTRACT

This report summarizes the surgical experience and early results obtained at four surgical centers in the northeast and south of Brazil. From December 1977 to September 1986, 95 operations were performed on 93 patients, ages 11-59. Bilateral lesions occurred in 42 patients, right lesions in 39, and left lesions in 12. Ventricular decortication and removal of thrombi were performed in all. In right-sided lesions, the tricuspid valve was substituted by a bioprosthesis in 34 cases, and substituted by a tilting disk valve in 1 case. In 4 patients, the valve could be preserved. The left-sided lesions led to valve substition by a bioprosthesis in 11 cases, and preservation of the valve in 1. The bilateral lesions needed bioprosthesis in the mitral position in 37 patients, and a disk valve in 2. In these 39 instances, the valvular procedure was insertion of a tricuspid bioprosthesis. Three tricuspid and three mitral plasties were performed. The overall mortality was 20% (26.2% for bilateral lesions, 14.6% for the right-sided lesions, and 20% for the left-sided lesions). The main cause of death was low cardiac output. Aside from a variable degree of right and left ventricular failure, many other non-fatal complications clouded the postoperative course. Complete AV blocks occurred in 10 cases, with the need for permanent pacing in 7 survivors. The mortality and morbidity in the present series is in keeping with the results reported in current literature. Regarding the advanced stage of their patients' disease, the authors agree with the recommendation for earlier surgical intervention.


Subject(s)
Endomyocardial Fibrosis/surgery , Adolescent , Adult , Arrhythmias, Cardiac/etiology , Bioprosthesis , Brazil , Cardiac Catheterization , Child , Cineradiography , Echocardiography , Endomyocardial Fibrosis/pathology , Endomyocardial Fibrosis/physiopathology , Female , Heart Valve Prosthesis , Humans , Male , Middle Aged , Mitral Valve/surgery , Multicenter Studies as Topic , Postoperative Complications , Thrombosis/surgery , Tricuspid Valve/surgery
8.
Tex Heart Inst J ; 12(1): 33-41, 1985 Mar.
Article in English | MEDLINE | ID: mdl-15227039

ABSTRACT

In a 10-month period, 68 patients underwent saphenous vein bypass revascularization without extracorporeal circulation. Distal sutures were performed with interruption of coronary flow without any devices for perfusion of the coronary artery; the proximal sutures were completed with tangential clamping of the aorta. Most frequently, the anterior descending and the distal right coronary arteries were revascularized; of 225 patients who underwent bypass surgery, this technique was possible in 68 cases (30.2%). The 30-day hospital mortality was 1.5%, and perioperative myocardial infarction, as determined by daily electrocardiograms (ECGs) and creatine phosphokinase isoenzyme (CKMB), occurred in two patients. Control hemodynamic studies were performed in 22 of the 68 patients (32.4%) with a patency rate of 84.2% in the grafts restudied.

9.
Tex Heart Inst J ; 12(1): 65-71, 1985 Mar.
Article in English | MEDLINE | ID: mdl-15227043

ABSTRACT

We describe a modification of the Blalock Taussig anastomosis, with the interposition of a glutaraldehyde-tanned umbilical vein graft between the subclavian and pulmonary arteries. This operation was performed in 64 children: 11 were less than 1 month of age (17.2%), and 23 were between 1 and 6 months of age (34.9%). Hospital deaths occurred in six patients-all less than 6 months of age (9.4%). There was no instance of shunt occlusion noted. The clinical course was uneventful among survivors, except for one patient who died of endocarditis in the late postoperative follow-up. The shunt procedure may be performed very rapidly, with minimal dissection, allowing the use of a graft larger than the diameter of the subclavian artery. This modification of the Blalock Taussig operation compares favorably with our previous experience with other shunt procedures and may be considered a valuable alternative in the palliative surgical treatment of several malformations with severe pulmonary oligemia.

15.
Rev. bras. cir ; 73(1): 15-8, 1983.
Article in Portuguese | LILACS | ID: lil-15618

ABSTRACT

E apresentado um caso de aneurisma congenito de tronco braquiocefalico esquerdo que apresentava sintomas de dispneia e dor toracica e que foi retirado atraves de esternotomia mediana. A revisao da literatura demonstrou 14 casos de cava superior e quatro casos de tronco branquiocefalico.A terapeutica empregada foi conservada nos casos de aneurismas fusiformes e cirurgica nos saculares sintomaticos


Subject(s)
Adult , Humans , Male , Brachiocephalic Trunk , Intracranial Arteriovenous Malformations , Mediastinal Neoplasms , Vena Cava, Superior
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