Current smoking predicts increased operative mortality and morbidity after cardiac surgery in the elderly.

Objectives: The effect of preoperative smoking status on the outcome of cardiac surgery remains unclear. Preoperative cessation may be associated with reduced postoperative pulmonary complications and in older patients preoperative smoking status appears to have a greater impact on outcome. This study was designed to assess the relationship between age, preoperative smoking status and outcomes from cardiac surgery.

Ventricular septal defect following disobliteration of right coronary artery.

Reperfusion injury is thought to occur during coronary recanalisation but rarely produces clinically significant effects other than arrhythmia. We report an unusual case of Ventricular Septal Defect (VSD) developing after successful disobliteration of the right coronary artery. In this case clinical, electrocardiographic and biochemical evidence of myocardial injury developed 6 hours after successful percutaneous recanalization of the infarct related artery.

Bilateral tension pneumothoraces following coronary artery bypass grafting.

It is an unusual case of bilateral tension pneumothoraces developing in the postoperative period in a patient who underwent total arterial revascularization for two vessel coronary artery disease. The patient had been a previous heavy smoker and at operation had been noted to have thin walled lung parenchyma with multiple small bullae mainly in the left upper lobe. He suddenly developed bilateral pneumothoraces following intermittent continuous positive airway pressure requiring initially bilateral needle decompression followed by chest drain insertion.

The effect of a large proximal haemodialysis arterio-venous fistula on weaning off cardiopulmonary bypass: case report.

An increasing number of renal dialysis-dependent patients with Arterio-Venous fistulae are undergoing cardiac surgery.The fistula has important effects on systemic hemodynamics in dialysis patients. The flow is significantly and positively related to cardiac output and cardiac index, and inversely related to pulmonary vascular resistance.

Clinical experience with assisted venous drainage cardiopulmonary bypass in elective cardiac reoperations.

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.

Does pleurotomy during internal mammary artery harvest increase post-operative pulmonary complications?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether pleurotomy during internal mammary artery (IMA) harvest increases post-operative pulmonary complications. Altogether, 154 papers were found using the reported search, of which 8 presented the best evidence to answer the clinical question.

Is there a role for prophylaxis against atrial fibrillation for patients undergoing lung surgery?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed whether prophylactic anti-arrhythmic drugs may prevent atrial fibrillation (AF) following lung resection. Altogether 457 papers were found using the reported search, of which 14 presented the best evidence to answer the clinical question.

Aortic valve replacement with the Sorin Pericarbon Freedom stentless valve: five-year follow up.

Background And Aim Of The Study: Presumed benefits from stentless bioprostheses include larger orifice areas with lower transvalvular gradients, and improved hemodynamic flow characteristics and annular mechanics. Herein are reported the results of a large series of the Sorin Pericarbon Freedom stentless valve implanted in the aortic position.

Methods: Between July 1998 and June 2003, a total of 102 consecutive patients (58 males, 44 females; mean age 71.

Massive bilateral pulmonary emboli complicating coronary artery bypass grafting: a case report.

We report an unusual case of massive bilateral pulmonary emboli following single coronary artery bypass grafting on cardiopulmonary bypass. The patient was admitted electively, received deep vein thrombosis prophylaxis, and had no clinical evidence of deep vein thrombosis in the perioperative period. On the tenth postoperative day he developed sudden dyspnea and a diagnosis of pulmonary embolus was made with computed tomography.