| Clinical experience with assisted venous drainage cardiopulmonary bypass in elective cardiac reoperations. | |
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MedLine Citation:
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PMID: 18270133 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Reoperative cardiac surgery is associated with substantial morbidity and mortality due to technical problems at sternal reentry, which can result in laceration of the right ventricle, innominate vein injury, or embolization from patent grafts. To minimize the risk associated with reentry, we adopted the method of assisted venous drainage in the cardiopulmonary bypass circuit with peripheral cannulation for cardiac reoperations. From March 1999 to May 2003, a series of 52 patients (38 males; mean age 48.7 years, range 4 months to 78 years) underwent cardiac reoperations performed with centrifugal pump venous-assisted cardiopulmonary bypass. EuroSCORE was 7.34 +/- 3.9 (range, 4-19). The reoperations were coronary artery bypass graft (25 patients), valve replacement/repair (18 patients), and complex pediatric procedures (11 patients). The studied adverse events were structural damage at reentry, mortality, blood loss, stroke, and hemolysis. Complications at sternotomy were damage to the innominate vein (1 patient) and aorta (1 patient) with blood loss of 625 and 225 mL, respectively. Four patients required intraaortic balloon pump or extracorporeal membrane oxygenation (n = 1) for hemodynamic support on weaning off cardiopulmonary bypass. Three patients died in the postoperative period. Our experience with centrifugal pump-assisted venous drainage in cardiac reoperations has shown excellent results, with reduced risk of damage to vital structures on sternal reentry. In cases in which structural damage did occur, blood loss was minimal. |
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Authors:
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Brian Nyawo; P Botha; T Pillay; S C Clark; K Tocewicz; J Forty; J R L Hamilton; P Hill; A Hasan |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The heart surgery forum Volume: 11 ISSN: 1522-6662 ISO Abbreviation: Heart Surg Forum Publication Date: 2008 |
Date Detail:
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Created Date: 2008-02-13 Completed Date: 2008-03-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100891112 Medline TA: Heart Surg Forum Country: United States |
Other Details:
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Languages: eng Pagination: E21-3 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle upon Tyne, United Kingdom. bcnyano@yahoo.co.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Cardiac Surgical Procedures / instrumentation* Cardiopulmonary Bypass / methods* Child Child, Preschool Female Health Status Indicators Humans Infant Male Middle Aged Reoperation* Retrospective Studies Risk Factors Sternum / surgery Suction / instrumentation, methods* Treatment Failure* Treatment Outcome Vacuum Curettage / instrumentation*, methods |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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