The Characteristics of Postoperative Mediastinitis During the Changing Phases of Cardiac Surgery.

Background: Mediastinitis is a serious complication of open heart surgery associated with high mortality, considerable health care costs, and prolonged hospital stay. We examined characteristics and incidence of mediastinitis during 29 years when indications and patient material have been in a process of change.

Methods: This was a retrospective population-based study comprising all mediastinitis patients more than 16 years of age after open heart surgery between 1990 and 2018 from a population of 1.

Unilateral pulmonary oedema after minimally invasive and robotically assisted mitral valve surgery.

Objectives: Unilateral pulmonary oedema (UPO) is a severe complication of minimally invasive cardiac surgery. UPO rates and UPO-related mortality vary considerably between different studies. Due to lack of consistent diagnostic criteria for UPO, the aim of this study was to create a reproducible radiological classification for UPO.

Outcome of aortic valve replacement with bioprostheses in the elderly.

Background And Aim Of The Study: Today, the elderly population continues to increase worldwide, and rates of aortic stenosis (AS) climb with age. Since aortic valve replacement (AVR) is the current treatment for elderly patients with symptomatic AS, the number of patients undergoing AVR is expected to grow.

Methods: Among patients operated on at Helsinki University Hospital between 1992 and 1997, a cohort (n = 145) was followed after AVR with a bioprosthesis.

Improved neurologic outcome after implementing evidence-based guidelines for cardiac surgery.

Objective: A high incidence of neurologic complications was observed in the year 2001 in cardiac surgical patients in this department. This article attempts to show the impact of changing and optimizing management protocols on the incidence of neurologic morbidity after cardiac surgery.

Design: An observational study of cardiac surgical patients.

Universal leukocyte reduction of transfused red cells does not provide benefit to patients undergoing cardiac surgery.

Objective: A policy of universal leukocyte reduction of the blood supply in Finland was implemented at the beginning of 2003. The aim of the present evaluation was to determine the potential role of leukocyte-reduced red blood cells in decreasing postoperative infections.

Design: A retrospective cohort study.

Inhibition of thrombin during reperfusion improves immediate postischemic myocardial function and modulates apoptosis in a porcine model of cardiopulmonary bypass.

Objective: Transient left-ventricular dysfunction because of myocardial reperfusion injury is a significant problem after cardiac surgery, but the underlying complex pathophysiology is still poorly understood. The authors studied early functional recovery of the postischemic myocardium and explored potential effects of thrombin inhibition on procoagulatory, proinflammatory, and proapoptotic features of myocardial ischemia-reperfusion injury.

Design: A randomized, blinded study.

Risk evaluation of cardiac surgery in octogenarians.

Objective: To assess the predictive value of risk factors in the European System for Cardiac Operative Risk Evaluation (EuroSCORE) for cardiac surgery on octogenarians.

Design: An observational study of octogenarians undergoing cardiac surgery and average-aged controls matched according to the cardiac surgical procedure.

Setting: A university hospital.

Activated protein C in the cardioplegic solution on a porcine model of coronary ischemia-reperfusion has deleterious hemodynamic effects.

Purpose: In reperfusion injury activation of coagulation and inflammation contribute to organ dysfunction. Activated protein C (APC) exhibits anticoagulant and anti-inflammatory properties in models of reperfusion injury. We hypothesized that APC could be cardioprotective after ischemia and cardiopulmonary bypass (CPB).

Recombinant hirudin enhances cardiac output and decreases systemic vascular resistance during reperfusion after cardiopulmonary bypass in a porcine model.

Objective: Cardiopulmonary bypass and surgical stress are accompanied by a systemic inflammatory response and activation of coagulation. Thrombin forms fibrin and activates platelets and neutrophils. Consequently, disseminated microthrombosis might increase capillary vascular resistance and thus impair reperfusion.

N-acetylcysteine as an additive to crystalloid cardioplegia increased oxidative stress capacity in CABG patients.

Objective: This prospective, randomized study was designed to assess the effects of N-acetylcysteine (NAC) in coronary artery bypass graft (CABG) patients.

Design: Thirty-five consenting CABG patients with normal myocardial function were randomly divided into control (C) patients (N = 20) who received crystalloid (Plegisol) cardioplegia, and NAC patients receiving NAC in a 0.04 mol/l solution (N = 15) in Plegisol.