Cardiovascular surgery (London, England)最新文献

{"title":"Stripping operation with preservation of the calf saphenous veins for primary varicose veins: hemodynamic evaluation","authors":"Toshiya Nishibe ,&nbsp;Masayasu Nishibe ,&nbsp;Fabio Kudo ,&nbsp;Jorge Flores ,&nbsp;Keiko Miyazaki ,&nbsp;Keishu Yasuda","doi":"10.1016/S0967-2109(03)00080-2","DOIUrl":"10.1016/S0967-2109(03)00080-2","url":null,"abstract":"<div><p><em>Purpose.</em><span> To study early changes in venous hemodynamics in stripping operation with preservation of the calf saphenous veins.</span></p><p><em>Patients and methods.</em><span><span><span> From October 1999 to December 2000, 110 extremities of 73 patients were treated for primary varicose veins. Based on preoperative ascending venography, 40 extremities underwent the groin-to-knee stripping of the </span>GSV, 20 underwent the proximal division of the LSV, and 50 received combinations of both surgeries. To evaluate venous hemodynamic changes, air </span>plethysmography was performed before operation and 7–14 days after operation.</span></p><p><em>Results.</em><span> The venous volume, venous filling index and residual volume<span> fraction were improved after surgery, but the ejection fraction did not change. The overall incidence of nerve injury was 4.5% (five limbs).</span></span></p><p><em>Conclusions.</em><span> In stripping operations, the preservation of the calf saphenous veins, which is shown to be advantageous in reducing saphenous or sural nerve injuries, does not adversely affect early venous hemodynamic improvement.</span></p></div>","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 341-345"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00080-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22562731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive coronary artery bypass grafting in high-risk patients. Late follow-up with assessment of left internal mammary artery graft patency and flow by exercise transthoracic Doppler echocardiography","authors":"U. Sunderdiek ,&nbsp;G.A. Kalweit ,&nbsp;R. Marx ,&nbsp;J.D. Schipke ,&nbsp;E. Gams","doi":"10.1016/S0967-2109(03)00026-7","DOIUrl":"10.1016/S0967-2109(03)00026-7","url":null,"abstract":"<div><p><span><span>Patients with significant risk factors are at increased risk of higher mortality and morbidity (9–16%) after CABG-procedures with cardiopulmonary bypass (CPB). When catheter interventions are not applicable and conventional </span>CABG with CPB are considered to have an unacceptable perioperative risk, these patients (</span><em>n</em>=35) were scheduled for minimally invasive coronary artery bypass grafting (MIDCAB).</p><p><span>Patients and methods: The risks leading to exclusion of conventional CABG procedures were: extremely impaired LV-function (EF&lt;20%), severe pulmonary diseases, malignant carcinoma, compromised </span>coagulation system<span>, age &gt;80 years with impaired physical constitution, redo-procedures after complicated initial operation, symptomatic descending thoracic aortic aneurysm, ongoing long-term intensive care treatment with unclear prognosis. All patients received the LIMA<span> as a single graft to the LAD. One year follow-up was performed using transthoracic Doppler echocardiography at rest and during exercise.</span></span></p><p>Results: In 20 patients incomplete revascularization was accepted. There was no mortality, while signs for myocardial infarction were seen in two patients. Twenty-nine patients (82%) showed clear improvement of clinical symptoms, one patient needed further conventional CABG.</p><p>Nine to thirteen months postoperatively (mean 10.8±1.6 months), there were two deaths due to noncardiac reasons. Three of the survivors (<em>n</em><span>=33) had symptoms of angina pectoris<span><span>. Exercise tests revealed an improved stress tolerance (NYHA class improved from preop. III–IV to postop. I–II). The </span>IMA graft flow increased significantly with exercise in all patients. Flow patterns in both flow velocity and volume changed to diastolic-dominant, and the ratio of diastolic to systolic time–velocity integral of &gt;1.5 excluded a graft stenosis.</span></span></p><p>Conclusions: In high-risk patients, with an increased likelihood of perioperative morbidity and mortality, the MIDCAB procedure can be performed accurately and safely. Even after incomplete revascularization of some high-risk patients, exercise tolerance was improved. Transthoracic Doppler echocardiography proved to be a clinically useful noninvasive method of assessing IMA graft function at rest and during exercise. Despite the small patient population, our late follow-up results suggest the potential benefit of MIDCAB for patients with otherwise inoperable heart disease.</p></div>","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 389-395"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00026-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22564041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: The impact of early ischemic preconditioning on spinal cord injury (Yao 747)","authors":"T Ueno ,&nbsp;T Itoh","doi":"10.1016/S0967-2109(03)00072-3","DOIUrl":"https://doi.org/10.1016/S0967-2109(03)00072-3","url":null,"abstract":"","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 430-431"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00072-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89995021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcome of aortic valve replacement in the elderly","authors":"Bruno Chiappini,&nbsp;Marcello Bergonzini,&nbsp;Simona Gallieri,&nbsp;Davide Pacini,&nbsp;Angelo Pierangeli,&nbsp;Roberto Di Bartolomeo,&nbsp;Giuseppe Marinelli","doi":"10.1016/S0967-2109(03)00104-2","DOIUrl":"10.1016/S0967-2109(03)00104-2","url":null,"abstract":"<div><p>Since elderly patients are being referred for surgery in increasing numbers, we reviewed the clinical outcome of 459 consecutive patients aged 70 to 89 years, who had aortic valve replacement between 1993 and 2000. We subdivided the study population into three groups: in Group 1 we included patients aged 70–74 years old; in Group 2 patients aged 75–79 years old; and in Group 3 patients aged 80 years old or older.</p><p><span><span>An isolated AVR was performed in 289 patients (63%), concomitant coronary artery bypass graft (CABG) in 168 patients (36.6%), an isolated </span>ventricular septal defect<span> (VSD) closure in one patient (0.2%) and an isolated atrial septal defect (ASD) closure in one patient (0.2%). The overall perioperative mortality rate was 7% (32 patients), without significant differences among the three groups (</span></span><em>P</em>=0.88).</p><p>Our study confirms the good outcome of aortic valve replacement in elderly patients even in octagenarians and only concomitant CABG procedures increase the operative risk, reducing long-term survival (<em>P</em>&lt;0.05).</p></div>","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 359-365"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00104-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22562734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent warm blood cardioplegia induces the expression of heat shock protein-72 by ischemic myocardial preconditioning","authors":"M Chello ,&nbsp;P Mastroroberto ,&nbsp;G Patti ,&nbsp;A D’Ambrosio ,&nbsp;G Di Sciascio ,&nbsp;E Covino","doi":"10.1016/S0967-2109(03)00078-4","DOIUrl":"10.1016/S0967-2109(03)00078-4","url":null,"abstract":"<div><p><em>Objective</em><span>: Recent studies have demonstrated that the induction of heat shock protein-72 (HSP72) by different stimuli preserves the heart function after cardioplegic arrest. Based on these findings, we investigated whether intermittent warm blood cardioplegia would induce changes in the myocardial expression of HSP72.</span></p><p><em>Methods</em><span><span>: Forty patients scheduled for aortocoronary bypass<span> were randomly assigned to receive either cold or warm intermittent blood cardioplegia. In all patients HSP72 and HSP72 mRNA were assayed in biopsies from the right atrium at baseline, and during the reperfusion period. Plasma CK-MB and troponin-T, and </span></span>myocardial oxygen extraction and lactate release were also measured.</span></p><p><em>Results</em><span>: In both groups, myocardial expression of HSP72 increased throughout the reperfusion period, but the values of HSP72 band lengths were significantly higher in the warm group. Correspondingly, HSP72 mRNA levels increased progressively in both groups, with significant difference between groups observed in biopsies at the reperfusion. Warm blood cardioplegia was associated with lower levels of CK-MB and troponin-T. Myocardial oxygen extraction and lactate release were higher during intermittent warm cardioplegia, indicating a more profound ischemic anaerobic metabolism in the warm group.</span></p><p><em>Conclusions</em><span>: Intermittent warm blood cardioplegia induces an increased expression of HSP72 and it is associated with a better myocardial protection<span>, by a mechanism involving a variant of the classical ischemic preconditioning model.</span></span></p></div>","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 367-374"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00078-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22562735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical claudication associated with overuse injury in patients with chronic compartment, functional entrapment, and medial tibial stress syndromes","authors":"William D Turnipseed","doi":"10.1016/S0967-2109(03)00074-7","DOIUrl":"10.1016/S0967-2109(03)00074-7","url":null,"abstract":"","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 421-423"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00074-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22564046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of early ischemic preconditioning on spinal cord injury","authors":"Ioannis K Toumpoulis,&nbsp;Constantine E Anagnostopoulos∗","doi":"10.1016/S0967-2109(03)00073-5","DOIUrl":"10.1016/S0967-2109(03)00073-5","url":null,"abstract":"","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 429-430"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00073-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22564048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective effect of N-acetylcysteine and hypothermia on the spinal cord ischemia–reperfusion injury","authors":"Omer Cakir ,&nbsp;Kemalettin Erdem ,&nbsp;Ahmet Oruc ,&nbsp;Nihal Kılınc ,&nbsp;Nesimi Eren","doi":"10.1016/S0967-2109(03)00077-2","DOIUrl":"10.1016/S0967-2109(03)00077-2","url":null,"abstract":"<div><p>The purpose of this study was to investigate the effect of <em>N</em><span><span>-acetylcysteine (NAC) on spinal cord ischemia–reperfusion (I–R) in rabbits. Thirty rabbits were divided into five equal groups, group I (sham-operated, no I–R), group II (control, only I–R), group III (I–R+NAC), group IV (I–R+hypothermia), group V (I–R+NAC+hypothermia). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery<span> and above the aortic bifurcation. Forty-eight hours postoperatively, the motor function of the lower limbs was evaluated in each animal according to Tarlov Score. Spinal cord samples were taken to evaluate the histopathological changes. The sham-operated rabbits (group I) showed no neurologic deficit (Score=4). </span></span>Paraplegia<span> (Score=0) developed in all rabbits in the control group (group II). Administration of 50 mg/kg of NAC (group III) resulted in significant reduction of motor dysfunction (Score=3.1±1.3, </span></span><em>p</em>=0.002). Application of hypothermia alone (group IV) showed significant recovery of motor functions (Score=3.0±1.1, <em>p</em>=0.002), and combination of hypothermia and 50 mg/kg of NAC (group V) showed complete recovery of lower limb motor function (Score=4, <em>p</em><span><span>=0.001). Histologic examination of the spinal cord in rabbits with paraplegia revealed several injured neurons. The cords of animals with no motor function deficits showed only minimal cellular infiltrates in the gray matter, and there was good preservation of nerve cells. NAC showed protective effects of the spinal cord. Moderate hypothermia alone also showed protective effects. Combined use of NAC and hypothermia resulted in highly significant recovery of </span>spinal cord function.</span></p></div>","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 375-379"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00077-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22562736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation of the variables associated with normal and delayed hospital discharge following first time isolated coronary artery bypass graft surgery","authors":"M.G Cox","doi":"10.1016/S0967-2109(03)00024-3","DOIUrl":"10.1016/S0967-2109(03)00024-3","url":null,"abstract":"<div><p>The optimum day for discharge after coronary artery bypass graft (CABG) surgery has been subject to some debate yet there has been a steady increase in the number of patients discharged within 5 days of surgery. Delayed discharges may result in the under use of surgical capacity and impact upon patient outcomes.</p><p><span>The author conducted a retrospective; correlational study of 333 patients to investigate the variables associated with delayed discharge after CABG. The results suggest it is possible to identify patients likely to achieve a 5-day discharge from their age and Parsonnet score </span><span>[<em>Circulation</em>, 79(Suppl. I), 1989, 3]</span>. The introduction of a policy of adopting a 5-day discharge for those patients could maximise surgical capacity and improve patient outcomes. Further prospective study is recommended after the policy has been implemented to evaluate the effectiveness of age and Parsonnet score to predict a 5-day discharge.</p></div>","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 397-403"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00024-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22564042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidative stress and abdominal aneurysms: how aortic hemodynamic conditions may influence AAA disease","authors":"Ronald L Dalman","doi":"10.1016/S0967-2109(03)00075-9","DOIUrl":"10.1016/S0967-2109(03)00075-9","url":null,"abstract":"","PeriodicalId":79324,"journal":{"name":"Cardiovascular surgery (London, England)","volume":"11 5","pages":"Pages 417-419"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0967-2109(03)00075-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22564045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}