Publications by authors named "Arjuna Weerasinghe"

Structural failure of mechanical heart valves is associated with a high mortality, especially when the valve is implanted in the aortic position. We describe a case of early intermittent dysfunction of a bileaflet mechanical heart valve implanted in a 67-year-old female. Transthoracic and transoesophageal echocardiography demonstrated intermittent jamming of the leaflets in both the open and closed positions in the absence of any obvious obstruction.

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Minimally invasive direct coronary artery bypass grafting utilising an anterior mini-thoracotomy has traditionally been limited to surgical revascularisation for single or double vessel coronary disease. The widespread use of percutaneous coronary intervention has further limited the use of this technique. Minimally invasive direct coronary artery bypass grafting offers the advantage of avoiding a sternotomy, in patients with a higher risk of sternal wound dehiscence and infection.

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Objective: Platelets and monocytes possess haemostatic properties, but the clinical effect of platelet-monocyte interactions on haemostasis following coronary surgery is not known. The study characterises the platelet and monocyte responses in cardiac surgery and its impact on haemostasis.

Methods: In 1342 patients, changes in white blood cell counts (WBC), monocyte counts and platelet counts were measured.

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Background: Since the advent of off-pump coronary artery bypass grafting (OPCAB), comparisons have been made between it and on-pump coronary artery bypass grafting. Some observe a lesser incidence of acute renal failure requiring renal replacement therapy with OPCAB whereas others do not. The objective was to compare the occurrence of renal adverse outcome between on-pump coronary artery bypass grafting and OPCAB.

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Traditionally, the internal thoracic artery is harvested as a pedicle. In contemporary cardiac surgical practice, however, certain surgeons practice the internal thoracic artery-skeletonization technique. A systematic review of clinical studies reporting on the use of skeletonized internal thoracic arteries (SKT-ITA) has not yet been performed.

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Background: Atrial fibrillation is the most common postoperative complication in patients undergoing coronary artery bypass grafting (CABG) with advancing age having been shown to have a significant association with its incidence. This study aims to assess whether off-pump coronary artery bypass (OPCAB) reduces the incidence of atrial fibrillation in elderly patients.

Methods: A meta-analysis of all observational studies reporting a comparison between the two techniques in elderly patients (> 70 years) between 1999-2003 was performed.

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Background: Despite limitations the transvalvular gradient (TVG) still is commonly used in aortic stenosis when patients are referred for aortic valve replacement. We wished to ascertain if it had a role in predicting outcome from valve replacement rather than as an indicator of severity, specifically investigating if the TVG affected renal dysfunction, hospital stay, and medium-term survival after valve replacement.

Methods: Six hundred and twenty-three consecutive patients who had aortic valve replacement were identified and 211 of these patients were isolated as first time replacement for aortic stenosis that formed the final study group, and were followed up for up to 48 months.

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